Predicting Readmission Risks

Red emergency sign on a hospital building.

Align: A unified health system of physicians, hospitals and communities, wanted to reduce patient readmissions and improve patient and family education. Appraise: Improved care by predicting readmissions across all conditions and identifying top readmission drivers, which were previously buried in physician’s notes (unstructured).  The AI solution improved prediction accuracy to 93% with AI​, a 52%…

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Optimizing Benefits Verification

Customer service representative on call

Align: With rising costs and a prioritization of engaging the member population, the company needed an innovative approach to provider support. Appraise: Improved care through a better provider experience, reflected by a drastic reduction in the number of provider callers opting out of the IVR. Expanded margin by reduced average handle time for provider benefits…

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