Intelligent-Driven Workflows
– No Tickets Required
Healthcare operations require coordination across multiple teams, systems, and regulatory checkpoints. The Monument Intelligent Workflow Engine orchestrates this work—automating how cases move across departments while embedding decision intelligence into every step.
Configure Tasks in the Web UI and Link Them to Create Workflows
It acts as the operational backbone behind Monument modules such as Claims, Enrollment, Prior Authorization, Intake, and Appeals & Grievances, ensuring work is routed, reviewed, and completed efficiently. The result is faster turnaround times, reduced manual coordination, and consistent operational outcomes. It also learns over time and can recommend workflows.
Xpress™ Workflow Is Flexible to Any Core System Creating a Standardized Workflow Engine
Every operational request—whether a claim, enrollment update, prior authorization, or appeal—is treated as a case within the system. The workflow engine automatically routes these cases to the appropriate operational teams such as:
- Enrollment Operations
- Clinical Review
- Utilization Management
- Compliance
- Appeals Review
Work is assigned to department queues rather than individual users, enabling balanced workloads and operational flexibility.
As soon as one step is completed, the system automatically advances the case to the next stage in the process.
Embedded Decision Intelligence
The Monument workflow engine integrates configurable decision points that determine the next action in a process.
These decisions can be based on:
- operational rules
- plan policies
- benefit configurations
- AI-driven signals such as document classification or case triage
This enables the platform to automatically determine when a case can proceed automatically and when expert review is required.
The workflow engine also supports parallel processing, allowing cases to be reviewed simultaneously by teams such as Clinical Review, Compliance, and Policy Management.
Once all required reviews are completed, the system automatically advances the case to the next stage which significantly reduces overall processing time.
Workflows and Screen Layouts
Saved by Each Module/Core
System
Operational timelines are continuously monitored by the workflow engine.
The system tracks how long each case remains at a given stage and can automatically trigger actions when thresholds are reached, including:
- supervisor alerts
- priority routing
- automated notifications
- escalation to specialized teams
This ensures compliance with regulatory timelines and service commitments.
Business Configurable Workflows
Operational teams can configure workflows without engineering changes.
Administrative screens allow configuration of:
- workflow stages
- routing rules
- decision logic
- document requirements
- escalation paths
- SLA thresholds
This allows organizations to adapt quickly to regulatory changes, payer requirements, and operational improvements.
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