According to a report from JAMA, a consortium of peer-reviewed, general medical and specialty publications, the U.S. healthcare system faces $266 billion in annual administrative costs, contributing to increased industry-wide expenses.
To help address these challenges, Illinois-based claims management provider Effective Health Systems has partnered with Orlando-based ATOM Advantage, integrating ATOM’s AI-powered Record Ranger into its BaseLine.RPT platform.
This solution automates workers' compensation claims processing, transforming a slow, manual task into an efficient system that delivers results in minutes. BaseLine.RPT enables teams to focus on higher-value tasks, improving both operational efficiency and care outcomes.
By using Record Ranger, EHS clients can automate critical steps utilizing the BaseLine.RPT platform for medical authorizations, Utilization Review escalation and management, vendor assignment, and bill review, dramatically speeding up processing times.
This boosts efficiency and lowers costs, allowing claims administrators to focus on higher-value tasks and ensure faster care for injured workers.
“With the power of AI-driven automation, we’re providing a solution that not only streamlines the claims process but also enhances operational efficiency, allowing our clients to reduce administrative burdens while delivering faster, more accurate outcomes for injured workers,” said Don Adams, CEO of Effective Health Systems.
“Integrating ATOM Advantage’s Record Ranger technology into BaseLine.RPT marks an exciting leap forward for our clients. ATOM Advantage has been an outstanding partner in pushing the boundaries of innovation in workers' compensation.”
Up to 80% of health and insurance data is unstructured, making it difficult to process. Record Ranger is a scalable proprietary AI solution that converts unstructured data into actionable intelligence, reducing the administrative burden that typically hinders the claims management process.
Designed for self-insured employers, third-party administrators, and insurance carriers, Record Ranger enhances claims management by automating workflows with verified accuracy, reducing errors, and ensuring faster claims processing.
The technology drives faster, more accurate decision-making, significantly improving efficiency and reducing costs for claims administrators while ensuring quicker access to care for injured workers.
By partnering with Effective Health Systems, Record Ranger will initially process more than 10,000 claims monthly, with a substantial increase anticipated in the coming months. The partnership delivers five key advantages that transform claims processing:
Automated Efficiency: Before Record Ranger, claims administrators manually processed critical elements of the claims lifecycle. Now, these processes are fully automated, enabling clients to manage more claims with enhanced speed and precision.
Improved Accuracy with Human Oversight: Record Ranger’s accuracy rate, verified by subject matter experts at 98.5 percent, significantly reduces the chances of missing critical information, allowing claims administrators to resolve claims faster.
Reduced Administrative Load: Automation of routine tasks like medical authorizations and bill reviews frees up claims administrators to focus on high-value tasks, improving case management and reducing professional burnout.
Enhanced Transparency: Effective Health Systems' "trust and verify" interface allows claims administrators to view BaseLine.RPT's outputs in real-time, ensuring full control over claims data.
Faster Decision-Making: With Record Ranger's speed and accuracy, BaseLine.RPT enables timely, data-driven decisions for injured workers and providers, accelerating care and reducing claim costs.
“Administrative complexity drives significant waste in the healthcare system, and Record Ranger directly addresses this challenge,” said Lori Landon, Chief Product Officer at ATOM Advantage. “By integrating Record Ranger into BaseLine.RPT, we’re enabling their customers to process claims faster and with greater accuracy while reducing the administrative workload. This means more efficient operations and better outcomes for injured workers.”
“Our advanced proprietary AI models streamline workflows and empower decision-makers to act confidently and efficiently,” she added. “By transforming handwritten notes, utilization reviews, medical records, and complex insurance forms into actionable insights, Record Ranger is helping Effective Health Systems’ clients unlock the full potential of their data, reduce administrative burdens, and deliver better outcomes for injured workers and providers alike.”
If you would like to learn more about how Record Ranger can help manage workers' compensation claims, contact us here.
About Effective Health Systems:
Effective Health Systems (EHS) provides innovative claims management solutions designed to streamline workflows, reduce costs, and deliver faster results for stakeholders in the workers' compensation space. EHS’s BaseLine platform is trusted by organizations to enhance decision-making and improve care for injured workers. Learn more at www.effectivehealthsystems.com.