Next Best Action Recommender
3% revenue uplift for a large RCM company by improving operations
Enhance Quality
Accelerate Revenue
Headline Impact
+3%
Increase in Collections Across 600K+ Weekly Claims
Healthcare Revenue Cycle Management Recommendation Systems
+3%
Increase in collections from AI-powered recommendations
+12%
Improvement in claim liquidation rates
600K+
Claims processed weekly with AI augmentation

UniSlink

UniSlink — a large Revenue Cycle Management company processing over 600,000 claims weekly, with ~1,000 agents navigating 70,000+ diagnosis codes, 10,000+ CPT codes, 500+ insurance providers, and 300+ client protocols.

Scaling Expertise Across 70K+ Diagnosis Codes and 1,000 Agents

Scaling expertise was nearly impossible — high agent attrition and long training curves meant inconsistent claim handling across 70K+ diagnosis codes.

Agent comments were unstructured, riddled with abbreviations and typos, making them unreadable for audits and automation.

Claim allocation was suboptimal — agents spent time on predictable scenarios that didn't need intervention.

AI-Powered Claim Resolution and Agent Augmentation

We built three interconnected AI systems that augment agent decision-making, standardize documentation, and optimize claim allocation — all with PHI-safe architecture.

1. Claim Resolution Recommender
LLM-powered next-best-action suggestions based on diagnosis codes, insurance metadata, and historical claim activity — with PHI redaction before any data touches the model.
2. Comment Enhancement Engine
Automated structuring and correction of agent notes into clean, audit-ready logs for internal and patient communication.
3. Intelligent Claim Allocation
Categorical nearest-neighbor matching comparing new claims against historically resolved ones — vectorized algorithm reduced matching from 10 seconds to 0.25 seconds.

Powered By

LLM with PHI Redaction Azure Queue-Based Throttling Vectorized Matching Serverless Architecture Hallucination Guardrails Multithreaded Processing

Millions in Recovered Revenue Across 600K+ Weekly Claims

The recommendation engine drove a +3% increase in collections, +12% improvement in liquidation, and +3% faster month-on-month collection. Comment enhancement eliminated cognitive load on agents while producing audit-ready documentation. Intelligent allocation prioritized high-impact claims and eliminated wasted effort on predictable ones.

"Every percentage point in collections across 600,000 weekly claims translates to millions in recovered revenue."

— UniSlink Operations

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