CentralReach, the leader in Autism and IDD Care Software for ABA and multidisciplinary organizations, today announced the launch of CR ClaimCheckAI, the only fully-integrated, proprietary artificial intelligence solution designed to transform the claims process. CR ClaimCheckAI greatly enhances accuracy, compliance, and speed in submitting claims by automatically analyzing claims against specific payer rules and a comprehensive suite of compliance checks, quarantining any claims that don’t meet payer requirements allowing them to be fixed prior to submission.


As the only comprehensive fully-integrated claim check offering in the market, CR ClaimCheckAI optimizes the post-quarantine process by 1) automatically fixing issues like client and provider name mismatches, service locations, start and end times, and more, so clinical and administrative staff don’t have to and, 2) labeling issues that can’t be automatically repaired so staff can easily find and fix issues quickly. This is all done within CentralReach, eliminating the need to log into separate systems, transfer files, or perform any other suboptimal workflows that are required with a 3rd party solution.  As a result, customers will significantly reduce the number of claims denials, increase clean claims rates, and materially reduce audit risk, which will increase overall claims reimbursement rates and cash flow while reducing A/R and DSO levels.


"With increasing compliance mandates and payer scrutiny, improving claims performance is top of mind for all providers in the Autism and IDD Care market. Current solutions like ad hoc manual checks or the use of clunky, disconnected 3rd party tools do not enable providers to materially improve performance without significant manual processing that they can ill afford to do. CR ClaimCheckAI solves these issues and represents a significant leap forward in our commitment to leveraging technology to improve healthcare administration," said Chris Sullens, CEO of CentralReach. "By fixing a multitude of issues automatically and embedding the quarantine process within a provider’s current workflow, CR ClaimCheckAI will greatly enhance clean claims rates from the outset, accelerate reimbursements, and reduce operational burdens, that will in turn allow providers to scale their services faster and more effectively. It’s the first step toward our vision of creating the only fully integrated real time clean claims workflow in the industry, so stay tuned for more enhancements in the coming year.”


Traditionally, many autism and IDD care providers have relied on manual checks or suboptimal 3rd party solutions for some, but not all claims, before submission. On average, most providers only have the resources to check approximately 5-10% of claims manually. This not only increases the chance of errors but also delays the overall time to reimbursement. CR ClaimCheckAI automates these checks and provides a comprehensive review of each claim, ensuring they meet compliance criteria in a matter of seconds – something that would require multiple full-time professionals to accomplish on a regular basis. Due to high demand, customers must sign up for a waitlist to get access to the new solution. Sign up for the waitlist today.


Key features and benefits of CR ClaimCheckAI include: 

  • Integrated AI Technology: Seamlessly checks all claims against updated payer rules and performs various compliance-related checks.
  • Automatic Error Correction: Automatically fixes issues like client and provider name mismatches, service locations, start and end times, and more.
  • Pre-Submission Claim Quarantine: Instantly flags and labels errors that can’t automatically be corrected within the CentralReach platform, allowing for quick corrections.
  • Efficiency Boost: Significantly cuts down the time spent on manual claims reviews and third-party error rectifications.
  • Enhanced Compliance: Ensures claims are compliant with regulations and enables data corrections prior to submission, significantly reducing the risk of audits and penalties.


With the introduction of CR ClaimCheckAI, CentralReach continues to redefine administrative efficiency in healthcare, providing tools that are not only powerful and proactive but also seamlessly integrated into the daily workflows of healthcare providers. For more on Centralreach go to centralreach.com today.

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