Telephonic Case Management
Where AI Meets Empathy
Learn how Enlyte is transforming telephonic case management through cutting-edge AI technology.
Predictive and Demonstrated Risk Modeling
GenexEngage uses a sophisticated machine learning application to integrate claims, medical, and pharmacy data for comprehensive risk identification throughout the life of each claim. This system not only predicts high-risk cases at the onset through initial data feeds but also continuously monitors claim developments to adjust intervention strategies effectively. By leveraging predictive and demonstrated risk analytics, GenexEngage ensures timely and precise clinical interventions.
GenexEngage: Enhancing Efficiency with Predictive Analytics
GenexEngage transforms case management through predictive and demonstrated risk modeling, harnessing integrated data from claims, medical and pharmacy records. Our capability employs a machine-learning model to pinpoint potential risks at the earliest stages of a claim, facilitating prompt and precise allocation of clinical resources. Watch our video to learn more.
How GenexEngage Can Help Your Organization:
- Predictive Risk Insights: GenexEngage utilizes cutting-edge AI to analyze claims, medical, and pharmacy data from the start. This enables us to identify and act on high-risk claims before they escalate, ensuring timely interventions.
- Demonstrated Risk Monitoring: Beyond initial predictions, our platform provides ongoing, real-time assessments of each claim. This continuous monitoring allows for adaptive strategies that evolve with the claim, ensuring optimal management and resource allocation.
- Enhanced Claim Professional Efficiency: GenexEngage utilizes cutting-edge AI to analyze claims, medical and pharmacy data from the start. This enables the telephonic case managers to identify and act on high-risk claims before they escalate, ensuring timely interventions and minimizing employee time away from work.
- Seamless Integration: GenexEngage integrates smoothly with your existing claims system, reducing manual data entry and streamlining workflows. This decreases your claim professional’s workload and allows for more efficient telephonic case management processes.
Customizable and Responsive Solutions
Adaptability is key in our technology. We provide a customizable rules engine and flexible analytics that adapt to your unique operational needs, allowing for strategic interventions that are both timely and effective. This ensures that resources are allocated precisely where they are needed most.
Early Intervention Telephonic Case Management (TCM) Powered by GenexEngage
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Ensures allocation of clinical resources to the right claims at the right time
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Early intervention TCM first 60 to 90 days
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Deferred intervention TCM or FCM based upon unique claim attributes
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Cost-efficient nurse staffing models and workflow
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Reduces medical and indemnity costs
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Expedites RTW
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