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Demystifying medical insurance coverage

The processing of Explanation of Benefits (EOB) in healthcare is often cumbersome and prone to errors, leading to delays and misunderstandings for patients. Manual review of EOBs is timeconsuming and can result in incorrect billing and confusion about insurance coverage. Patients also wouldn’t easily understand all the coverage terms and that ended up taking time to explain.

Firstsource used its AI platform, FirstSenseAI to solve the complexities surrounding medical insurance coverage and billing.

Logo of Firstsource

Accurate processing of EOBs

FirstSenseAI Explanation of Benefits Copilot automates the analysis and processing of EOBs. By leveraging Azure OpenAI, it accurately interprets complex insurance details, matches services with coverage, and clarifies billing items. It also updates patient records and billing systems in real-time, ensuring accurate and efficient processing.

Reducing billing disputes

FirstSenseAI EOB Copilot enhances operational efficiency, drastically reducing the time taken to process and reconcile benefits. It also improves accuracy in billing and coverage explanations, leading to greater patient satisfaction and a significant reduction in billing disputes and administrative costs. Automation of EOB processing can lead to a 40-60% reduction in processing time. For a healthcare provider processing thousands of EOBs monthly, this could mean saving hundreds of hours, translating to significant cost savings.

Ritesh Idnani, MD & CEO, Firstsource

Ritesh Idnani

MD & CEO
Firstsource

At Firstsource, we’re excited about AI’s disruptive potential, unlocking possibilities and propelling innovation. Our commitment spans the AI lifecycle, utilizing frameworks, accelerators, and partnerships, showcased in our FirstSenseAI Studio. We prioritise AI democratization through programs like FirstColLab and The Digital Sprint, empowering every team member to lead industry transformation.
40%-60%
expected reduction in processing time

Firstsource is a digital-forward, people-first business process solutions company.
More details at https://www.firstsource.com