Meet Clinical Assistant,
an AI-Powered Prior Authorization
and Clinical Appeals Tool
Clinical Assistant summarizes medical chart data and other clinical support and checks them against industry databases such as InterQual, MCG, and health plan policies and then reduces the entire process so that a Clinician can make a final decision in minutes versus hours.
Scale with Leading Support
Unique market differentiator for Utilization Management and Case Management. Clinical Assistant allows health plans to reduce clinical costs and add scalability.
Expedite Approvals
- ›The Clinical Assistant identifies the reason for the Auth request or Appeal denial.
- ›It scans clinicals for the content that drove the request.
- ›It then links to the industry standard decision-making criteria.
- ›Decision in minutes! Approve, Deny, or Pend for further review.
“We have grown from about 450 members to over 25k in two years, so we needed the right systems and partner to keep up with our exciting growth! Meaningful change in health care starts with trusted relationships—collaborators who share your urgency and deliver with reliability. That’s Ken Stockman and the team at Monument Systems. They have automated many areas for us, including faxes, prior authorization, claims, MA enrollment and member services. With BPO and AI, they have delivered significant process improvements and savings, and we're receiving reports at a detail that we have not had before. When we share problems or feedback on improving the products, the results we get impact our bottom line. That's a true partnership.”
Gain Insights Powered By Clinical And Claims Intelligence
Reporting is real time and linked right within the dashboard.Our vision is to integrate clinical guidelines with claims historical data.
Grow with a Unified System
Automated decision making will reduce cost, increase scalability and improve quality. Innovation for Clinical Assistant includes:
- ›Use of the health plan's historical data to identify plan specific decision trends and guidelines.
- ›Create an end-to-end view of the decision-making process.
Our Modules - with or without BPO Services
Monument Xpress™ Claims
Xpress™ is a fully loaded core claims processing system but implemented in half the time, and at half the cost.
Learn MoreXpress™ Auth
AI-driven prior auth automation that accelerates approvals, ensures compliance, and improves provider and member experience.
Learn MoreXpress™ Communication
Secure, intelligent fax and communication automation that eliminates manual handling and integrates with plan workflows.
Learn MoreXpress™ Enroll
AI-driven enrollment for Medicare, Medicaid and Commercial lines of business. Connect direct with CMS.
Learn MoreXpress™ Appeals & Grievances
AI driven for more accurate case resolution while ensuring complex regulatory requirements and deadlines.
Learn MoreXpress™ Clinical Assistant
Standalone AI web + mobile tool for clinical decisions. Human-approved for Prior Auth and Clinical Appeals.
Learn MoreXpress™ Intake
Automate and categorizes intake from multiple channels (portal, fax, email, EDI and API), validates eligibility, classifies and routes it forward.
Learn MoreXpress™ Workflow
Configurable web + UI to build and link tasks into workflows. Models improve with time and usage.
Learn More