Eligibility & Benefits Verification
Preempt delays and denials before they start. Myndshft automated prior authorization solutions integrate with your existing workflow and systems. Verify eligibility and medical benefits in real-time and instantly access co-insurance, copay, deductible, and other plan details for 94% of covered U.S. lives.
Coordination of Benefits
Myndshft can identify other payers—even when they are not included as part of an eligibility verification request—and return detailed information on the primary, secondary and tertiary payers as part of a consolidated response. Best of all, Myndshft can provide this coordination of benefits functionality with just a single API call.
Insurance Discovery
Take advantage of innovative technology to explore and accurately identify the active coverage and payer specific benefits for patients. Intelligent algorithms search patient specific information for more than 2,000 payers, clearinghouse databases, and direct connections infrastructure to find more active coverage for healthcare billers.
Patient Financial Responsibility
How much does a patient owe? Myndshft can calculate patient financial responsibility so you know at the time of service. Better visibility enables you to assess patients’ propensity to pay, collect payments up front if necessary, or extend financing options to improve the likelihood of being reimbursed.
Automated Prior Authorization
Whether based on medical or pharmacy benefits, Myndshft automatically determines if a prior authorization is required and submits it directly to the payer or PBM via the optimal submission route. The platform then provides status monitoring in a single user interface. Machine learning and AI-enabled processes recognize patterns from payer responses and can dynamically update workflows to minimize the risk of denials or delays in payment.
CB.Claims Runs on CognitiveBus
CognitiveBus is our patented, integrated machine learning and blockchain platform that serves as a foundation for Myndshft automated prior authorization solutions.
Artificial Intelligence and Analytics
Artificial Intelligence & Analytics
Our AI and analytics layer employs a data warehouse that leverages a stream of de-identified data to build machine learning models and perform complex analytics. We use this to build valuable business models such as identification of fraud, waste, and abuse, payment risk modeling, and estimated authorization response times.
M:IA Ingest Engine
M:IA
M:IA is our systems integration and robotic process workflow engine. We use it to automate existing manual workflows and processes within an EHR or system of record and to make it easy for data ingest and egress to and from our applications.
Applications
Application
The application layer uses our rules engine to perform additional data validation and cleansing, scrubbing personal health information to de-identify data being sent to our analytics layer.
Payer Integration Layer
Payer Integration
The payer integration layer leverages our rules engine and library to make EDI submissions, maintain a library of always up-to-date payer portal workflow requirements, generate web portal submission requests, and schedule follow up events such as status checks.
CognitiveBus
CognitiveBus serves as the foundational platform layer upon which we build all Myndshft applications. It utilizes our fully integrated AI compute engine and native enterprise blockchain to enable us to quickly and easily build machine learning models, create new solutions, and derive insights from customer data. It is deployed within the HIPAA-compliant Google Cloud infrastructure and can scale dynamically.
Rules Engine
Self-Learning Rules Engine & Library
Myndshft utilizes smart contracts and an automated rules engine to consistently maintain payer prior authorization rules—including pricing and per diem information—for over 600 payers. Our comprehensive library of publicly available payer rules enables us to ensure that all patient interactions follow the requirements set by payers; both those that are published and those used in practice.
CognitiveBus® is our proprietary artificial intelligence compute engine, accelerator, toolkit, and native enterprise blockchain platform. We built it with speed, scale, and agility in mind.
Its “plug and play” tooling, industry accelerators, and cognitive building blocks remove the complexity associated with deploying artificial intelligence. It can also be deployed in as little as an hour, and can scale from a single node to thousands in just minutes.
Myndshft solutions run on top of CognitiveBus, which is why they are able to deliver instantaneous results, function as self-learning systems, and directly integrate with thousands of EMRs, health information systems, and financial management systems.
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