Claims extraction
Packs become fields; misses go to review.
Next Gen System builds production chatbots, Voice AI, bot & process automation, agentic systems, OpenAI integrations, and data services—wired to your workflows.
Next Gen System builds production chatbots, Voice AI, bot & process automation, agentic systems, OpenAI integrations, and data services—wired to your workflows.
Claims intake, eligibility voice, and portal work that actually finishes.
Built for payers and TPAs buried in attachments, member calls, and screens outside the core system.
Payer ops lose days to photocopy intake, eligibility calls, and work that lives in a portal the core system never learned. We extract claims packs into fields, contain member voice on status, and bot the leftover screens—with exceptions in a human queue.
Specific production work—not a generic “we do AI for this sector” list.
Packs become fields; misses go to review.
Eligibility and status without a cold IVR dump.
Work outside core, with an exception queue.
Agents start with the call notes, not a blank screen.
Next Gen System treats Healthcare payers as operating jobs with owners, integrations, and a handoff—not a slide of industry logos.
EOBs, claims, and attachments become usable fields so intake is not a marathon. Low confidence goes to a person. High confidence posts.
Members get eligibility and claim status on the phone. Live agents take judgment calls, and the notes travel with the member—no “start over.”
Unattended bots handle portal work outside core. When a screen breaks, the job pauses with evidence. It does not keep posting garbage.
Each row is a real job here, tied to a service your team can open.
Data Extraction
Claims, EOBs, and attachments become usable fields so intake is not a photocopy marathon.
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Voice AI
Members get eligibility and claim-status answers on the phone, with a live agent only when the case needs judgment—and the call notes travel with them.
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Bot Automation
Intake and portal work that lives outside your core system is done by unattended bots, then exceptions land in a human queue.
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Intake and the member line should finish—or land on a person with the notes. Overnight copy-paste is not a process.
EOBs, claims, and attachments become fields. High confidence posts; low confidence goes to review.
Eligibility and status on the phone. Agents take judgment calls with the thread attached—no “start over.”
Portal work outside core runs as a job. When a screen breaks, it pauses with evidence.
Containment is a measured rate. You see what still needs a human and why.
We scope the win, build with evals, and hand over a system your team can run.
We map high-ROI chatbot, voice, automation, or data use cases—then pick the first win that can reach production.
We design the system, integrate your stack, and prove quality with evals before wider rollout.
We ship with monitoring, feedback loops, and a clear runbook so your team can own the system.
Straight answers for Healthcare payers work with Next Gen System.
No. It prepares fields and status. Payment decisions stay in your core and with your staff.
We use the authentication you already run. We do not invent a second identity stack.
Depends on pack variety. We pilot the top formats, then expand—not a big-bang OCR dump.
We will pick the first production job, the systems it must touch, and what “done” looks like for your operators.
Share your use case. We respond within one business day.
