Invoice Checker

Why use the Invoice Checker?

Despite Claims Assessors having easy access to the AMA Guide to verify fees, insurers are still losing vast sums of money on claims leakage due to treatment providers continually overcharging insurance companies for their services. Mistakes can be easy to make with the AMA Guide being several hundred pages long, containing a few thousand codes, and taking into consideration what fee calculation rules that are to be applied. When invoices contain multiple codes, the process becomes extremely time consuming, arduous and confusing. 

Our Solution 

As part of our ongoing AI work around cost efficiencies in the insurance space, Kawaconn has developed an AI tool for the mitigation of claims leakage in the determination of requests for treatment and surgical options. The Invoice Code Checker significantly reduces the amount of time needed to confirm invoice amounts. Users are able to enter AMA/MBS codes into the search engine, which will automatically calculate the maximum invoice fee (according to guidelines) in just a few clicks. Fast and effective, claims staff can now efficiently compare their invoices and ensure claims leakage is avoided. The dramatic amount of time saved by staff will give them more time to proactively manage claims and achieve further reductions in claims expenses for your company.