Sensentia’s first product is an Automated Inquiry System that enables members and providers to verify benefits for health services online or through mobile devices by entering questions in natural language. The system has been proven to be more accurate (>95%) than a customer care center.
Our customers are the health insurance companies and administrators who bear the cost of servicing consumer inquiries. U.S. health insurers receive about 1 billion phone calls from their members and providers costing over $5B each year. About a quarter of these are benefit inquiries. EDI-based solutions exist for providers they have technical interfaces that are difficult to navigate and often cannot answer complex inquiries. Nothing currently exists for members to have their questions answered online.
Other applications that we are exploring include automated patient responsibility calculation, authorizations, clinical documentation improvement, claim coding, and claim adjudication.
Sensentia's core technology automatically reads and models the knowledge within any textual document and answers human questions or computational queries against it. The questions are asked and answered in natural language, structured forms or through automated dialogue helping consumers refine their questions. Answers are precise and succinct as opposed to estimates or potentially relevant links.