Medical 法案审查 Software and 服务

法案审查, Optimized for You

Enlyte's highly configurable bill review platform deploys powerful technology to help claims organizations process medical bills using accurate and up-to-date fee schedules and other benchmarks. Our proprietary platform is pre-integrated with the Enlyte family of solutions including our pharmacy and clinical software, allowing payers to more accurately manage claims and provide full visibility.



Enlyte's bill review platform is explicitly designed for the auto casualty and workers' compensation industries. 因此, it delivers the functionality and features claims organizations need to accurately adjudicate claims, review medical charges and manage regulatory compliance, helping you achieve better bill outcomes.

From intelligent workflows expertly customized to your business to integrated solutions, Enlyte's bill review platform--whether you're using SmartAdvisor or DecisionPoint can help you accurately adjudicate claims, increase operational efficiencies and contain costs.

特性 & 好处

Industry-Leading 法案审查 Software & 服务

From intelligent workflows expertly customized to your business to integrated solutions, our bill review platform can help you accurately adjudicate claims, increase operational efficiency and contain costs.

一流的技术 & 专业知识

Contain Costs and Spend More Focused Time on High-Value Tasks


Accelerate Medical Bill Ingestion & 处理


Maintain Regulatory Compliance

Highly Configurable Workflow Rules Engine

Increase Claim 处理 Efficiency and Improve 法案审查 Accuracy

Automation and Straight-Through 处理

Increase automation through powerful and intelligent business rules and machine learning


A 交付模型 Tailored to Your Needs

Enlyte offers its medical bill review platform to its clients via one of three methods:








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Our Technology Enabled 服务 handles your necessary, but often expensive internal operational tasks so you can shift focus to your business’ core competencies. When you outsource with Enlyte, we’ll serve your medical claims with our premier services and bill review expertise, 给你信心, satisfaction and trust you need when selecting a bill review services provider. You can be confident your medical claims are being served by the industry’s premier service provider with decades of bill review expertise.

Our team provides comprehensive bill review services, including:

  • 医疗帐单处理
  • 邮件收发室操作
  • 文档管理
  • 数据捕获
  • 供应商联络中心
  • Specialized third party liability demand services


Enlyte AuditPro

Our AuditPro bill auditing solution employs a unique blend of technology, data and expertise to detect billing errors, and validate and correct medical codes and charges against medical records for bill review pricing. The AuditPro solution addresses a wide range of bill types including professional and facility bills.


Enlyte’s specialty bill review solution provides proven and substantiated usual and customary pricing to help our customers consistently pay out-of-network medical bills when fee schedule pricing is exempt. Our Technology Enabled Specialty 法案审查 Solution is supported by a team of experienced 法案审查ers, 护士, 法律和合规专家.


Enlyte's direct-to-provider negotiation services helps secure discounted rates on medical bills using a variety of strategies including prompt-pay, data-enhanced and strategic negotiations. Mitchell's Negotiation 服务 can be utilized across Workers Compensation and Auto claims.


亚博真人官方版APP & 的见解

Get the latest insights and industry updates you need to know.


Mainstream use of generative AI has prompted claims leaders to explore how the technology can be used to improve claims management. And while GenAI certainly offers tremendous opportunities for the P&C行业, tech leaders must be diligent in ensuring the intricate knowledge and experience in claims management is integrated into these programs.


Combat Rising Medical Costs on First Party Auto Claims

Enlyte’s auto bill review solution reduced the medical bill by an average of 80%— so our customer pays 20 cents for every dollar charged. The injured individual gets five times the amount of the medpay/pip benefit. Accurately and efficiently reviewing medical bills minimized litigation and the labor spent reviewing bills.


How to Use Data to Influence Claim Decisions

Check out the key insights from our exclusive leader to leader webinar with Sentry 保险 experts. 观看网络研讨会, to discover how data is influencing claim decisions and grab valuable takeaways for your team. What do you need to do to make analytics matter? The key to making analytics matter is to make it actionable.