Resolve more exceptions, faster, and compliantly—with the Claims Exception Workspace. Through this joint offering, esolutionsONE Inc. and ServiceNow help payer organizations do away with complex manual processes and standardize workflows with an easy-to-integrate, purpose-built solution. This next-generation workspace integrates seamlessly with your system of record to help you streamline work across the enterprise and increase speed to value. 

Results/Outcomes:

- Improve operational efficiency to maximize impact. Never miss a required step or task with a low-code solution that includes step-by-step playbooks and prescriptive workflows.​
- Enhance employee, provider, and member experiences. Connect people, process, and technology with a single pane of glass for increased transparency and improved CSAT.​
- Control costs and mitigate risk. Improve efficiency, accuracy, and security to unlock untapped value, reduce costs, and mitigate organizational risk.​

Functional Features:

- Integration with claims platform​
- Knowledge Base: Help resources apply SOPs consistently​
- Exception-specific prescriptive workflow​
- OOTB patient details using Patient 360​
- Integrated downstream SOR updated with resolution outcomes​

Technical Features:

- Built on HCLS Service Management, HL7 FHIR data model​
- DocIntel: Next-level OCR that uses AI to learn over time​
- Subflows can be reused in other playbooks​