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    HiLabs offers several AI-powered healthcare products that analyze medical data to detect errors and discrepancies without human input. The case study is for creating a user application for one of HiLabs' products, MCheck, which uses pattern matching to identify issues in provider directories, claims data, and other areas. The case study should include assumptions, target users and use cases, a user flow, mockups of key screens, and a pricing strategy for the product. MCheck and HiLabs' other products work by analyzing medical claims, clinical, and provider data using unsupervised machine learning to find anomalies.

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    HiLabs offers several AI-powered healthcare products that analyze medical data to detect errors and discrepancies without human input. The case study is for creating a user application for one of HiLabs' products, MCheck, which uses pattern matching to identify issues in provider directories, claims data, and other areas. The case study should include assumptions, target users and use cases, a user flow, mockups of key screens, and a pricing strategy for the product. MCheck and HiLabs' other products work by analyzing medical claims, clinical, and provider data using unsupervised machine learning to find anomalies.

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    HiLabs offers several AI-powered healthcare products that analyze medical data to detect errors and discrepancies without human input. The case study is for creating a user application for one of HiLabs' products, MCheck, which uses pattern matching to identify issues in provider directories, claims data, and other areas. The case study should include assumptions, target users and use cases, a user flow, mockups of key screens, and a pricing strategy for the product. MCheck and HiLabs' other products work by analyzing medical claims, clinical, and provider data using unsupervised machine learning to find anomalies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    160 views3 pages

    Deck

    Uploaded by

    Kanna1927
    HiLabs offers several AI-powered healthcare products that analyze medical data to detect errors and discrepancies without human input. The case study is for creating a user application for one of HiLabs' products, MCheck, which uses pattern matching to identify issues in provider directories, claims data, and other areas. The case study should include assumptions, target users and use cases, a user flow, mockups of key screens, and a pricing strategy for the product. MCheck and HiLabs' other products work by analyzing medical claims, clinical, and provider data using unsupervised machine learning to find anomalies.

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    Case Study For APM Role

    Case Overview:
    HiLabs healthcare-focused artificial Intelligence (AI) solutions automatically detects data errors without human
    knowledge or input. It is a rare fusion of AI, big data, and medical ontologies. HiLabs has multiple products and each
    product addresses multiple use cases. It offers services and products to different healthcare agencies. The applicant is
    expected to create a user application for the same.
    It is expected that the case study consists of the following 5 slides-
    • Assumptions
    • Target Users and valid use cases (try to identify new potential users and use case as well)
    • Application user flow
    • Wireframes/Mockups of the important screens (HINT: identify user touch points. You can choose MCheck
    specific user flow for the mockup(s); use balasamiq for creating mockups)
    • Pricing of the product/solution: Identify the different pricing strategies and choose the best one by giving logical
    reason(s)/evaluation (Please use strategies that are relevant to the industry and context)

    HiLabs’ Products:
    • MCheck-It does comprehensive testing via pattern matching data comparison between source and target. It
    takes a proactive approach to detect frauds and provides rapid root cause analysis for every data discrepancy.
    MCheck is currently used in process validation, identifying issues in provider directories, identifying high dollar
    claims, clinical data automation and identifying data errors in downstream data like HEDIS measures
    • Other products include MCode (Identifies under coding in the data. This solution is particularly beneficial to the
    health plans), MSure (Identifies up coding in the data ie.it identifies medically unnecessary services that are
    solely for the purpose of generating insurance payments), MVision (allows for what if analysis to identify impact
    on RAF score and dollar impact) and MRead (ML-NLP based solution)

    Stakeholders:
    • Healthcare insurance companies (eg. Anthem, Aetna)
    • Service providers (eg. hospitals, pharmacy)
    • Members (individuals/families who have taken an insurance plan from a healthcare insurance company)
    • Government (eg. CMS) who are jointly involved with healthcare insurance companies for certain healthcare
    plans like Medicare Advantage

    Commonly Used Medical Data:


    • Claims data (information related to claims processing and submissions)
    • Clinical data (information related to hospital visits)
    • Provider directory data (information related to various hospital and care center networks that are part of
    different insurance plans)

    Process:
    The product can be used by the client in 2 ways-on-premises or on cloud. The on-premises flow chart is depicted below.
    If the product is used in cloud, the only difference is in its ingestion part where we services/products like AWS data
    exchange, Appflow, Fargate, AWS SFTP, Kinesis, AWS Datasync, AWS Data Migration services
    Case Study For APM Role

    Algorithm Overview:
    The products work on unsupervised ML techniques to identify millions of combinations of patterns, and then identify
    outliers in these patterns. The ML engine is further customized based on relevant user inputs/medical ontologies to
    fine tune the results (supervised learning)
    Case Study For APM Role

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