Whether you're looking to speed up pre-authorisation, reduce fraud, or gain strategic visibility — Acclaim is designed to deliver value across your entire operation.
| Stage | Use Case | Value Delivered |
|---|---|---|
| Pre-auth | Extract claim form, identify missing documents | First time right submission & faster pre-auth |
| Pre-auth Submission | Classify claim documents automatically | Reduced query rate |
| Claims Processing | Extract structured data at discharge | Reduce manual entry, faster TAT, higher accuracy |
| Stage | Use Case | Value Delivered |
|---|---|---|
| Pre-auth | Automated claim document review | Faster approvals |
| Claims Intake | Automate claim registration | Reduced processing effort |
| Claims Processing | Structured digital data pipeline | Improved accuracy |
| Fraud Detection | Fraud trigger detection | Prevent leakage |
| Claims Validation | Exception-based review workflow | Reduce HiTL overhead |
| Stage | Use Case | Value Delivered |
|---|---|---|
| Pre-auth | AI-assisted claim document interpretation | Faster pre-auth decisions |
| Claims Processing | Co-Pilot assisted claim adjudication | Improved productivity |
| Fraud Detection | Real-time fraud risk scoring | Early fraud detection |
| Claims Operations | Operational dashboards | Performance monitoring |
| Network Mgmt | Provider analytics | Identify anomalies |
| Portfolio Insights | Claims trend analysis | Strategic planning |
| What's included | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|
| Document digitisation & OCR | ✓ | ✓ | ✓ |
| Automatic document classification | ✓ | ✓ | ✓ |
| Structured data extraction | ✓ | ✓ | ✓ |
| Clinical coding & categorisation | — | ✓ | ✓ |
| Human review for exception cases | — | ✓ | ✓ |
| Fraud, waste & abuse detection | — | ✓ | ✓ |
| Operational dashboards & reporting | — | — | ✓ |
| AI Co-Pilot for claim adjudication | — | — | ✓ |
| Portfolio & provider analytics | — | — | ✓ |
Acclaim is designed to deliver value from day one — and expand as your needs evolve. There's no big-bang implementation. You choose where to start and when to scale.
Connect Acclaim's document intelligence APIs to your existing systems. Most customers go live within weeks — no workflow overhaul required.
Unlock AI-assisted adjudication, real-time fraud scoring, and strategic analytics that give your leadership team the intelligence to drive better outcomes across your entire portfolio.
Walk through 4 quick steps to build your personalised business case. Your savings estimate updates live as you go.
| Category | Current / yr | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|---|
| Non-Medical / Non-Claimable | — | — | — | — |
| Tariff Overcharging | — | — | — | — |
| Waste & Abuse — Unnecessary Treatment | — | — | — | — |
| Medicine Price Overcharging | — | — | — | — |
| Total savings recovered | — | — | — | — |
| Cost / benefit category | Without Acclaim | With Tier 1 | With Tier 2 | With Tier 3 |
|---|---|---|---|---|
| Processing cost per claim Based on your automation rate per tier |
— | — | — | — |
| Savings recovered — all categories What you catch with vs without Acclaim |
— | — | — | — |
| Net operational position | — | — | — | — |
| Acclaim platform fee Per-claim rate × annual volume |
— | — | — | — |
| Implementation cost (amortised) One-time cost ÷ contract years |
— | — | — | — |
| Net annual benefit vs status quo | Baseline | — | — | — |
How these numbers work — Your current savings baseline = % entered × annual claims spend. Non-Claimables (always on): Acclaim improves by +20%/50%/80% across Tier 1/2/3. Tariff Overcharging (requires Tariff add-on, Tier 2 & 3): +45%/75% improvement on baseline. Waste & Abuse (Tier 2 & 3 only, additive): Acclaim adds +0.5% of claimed spend on top of your current baseline without the Policy document; sharing the Policy document increases this to +1.5% of claimed spend. Medicine Price (always on): +10%/40%/70% across Tier 1/2/3. Productivity gain = reduction in cost per claim (25%/50%/70%) × annual volume. Add-on fees for Tariff and Policy configuration stack on top of base tier pricing. All figures are indicative estimates — actual results will vary.