Analyze & Protect
Your Medical Claims
An AI-powered medical claim auto-adjudication
clinical documentation/decision support system to identify claims' critical errors and
pitfalls.
Saudi's first advanced medical claim analysis technology
FEATURED ON
NexoRCM is built for all teams
RCM for Payers
Understand your medical claims better
- Measure unjustified medical claims
- Evaluate internal billing operation and compliance
- Measure level of compliance with regulations
Support your medical & RCM team
- Find accurate ICD10AM codes (Advanced code finder)
- AI powered clinical documentation (CDI)
- Order the right medical services (CDSS)
- Automate daily claims check (Claims Checkers)
Evaluate your Nphies readiness
- Internal service maping to CHI-BS
- MDS technical review
- Services, packages and bundling review
Evaluate your business potential
- Analyze your services utilization rates
- Identify operational & business potentials
- Benchmark your clinical and claims performance.
Automate approval and claims adjudication
- For medical necessity
- Medical coding standards (ACS 6th Edition)
- For regularly compliance
- For contractual compliance
- Medical policy compliance and abuse
- CHI IDF
Communicate with your policy holders
- Communicate the care plan with the policy holders
- Communicate approval or rejection reasons
Understand the medical trajectory of your policy holders
- Map your patient medical history and active conditions to the financial spending
- Analyze your policy utilization and justification
Compliant with Saudi CHI Guidelines & supports your digital transformation
We have built it on the latest technical and
medical standards directed by the Saudi CHI so you can operate without worry
CHI Billing System
ICD-10 AM
Saudi FDA
CHI Insurance Drug Formulatory
