Nexara Health • Revenue Cycle Automation • 180K documents/month • Updated: Dec 18, 2024 14:22 UTC
% of completions by AI confidence band • Last 30 days • Goal: >70% in High band
% of tasks requiring human intervention
% of completions with detected errors
30-day moving average • Model comparison
Concurrent agent utilization • Last 7 days
| Workflow Name | Task Category | Auto Rate | Escalation | Error Rate | Token $/Txn | P95 Latency | Model | Status |
|---|---|---|---|---|---|---|---|---|
| Prior Auth Extraction | Clinical Documentation | 91.2% | 8.8% | 0.8% | $0.031 | 3.1s | Fine-tuned v2.1 | Excellent |
| EOB Processing | Insurance Processing | 88.4% | 11.6% | 1.1% | $0.042 | 3.8s | GPT-4o | Excellent |
| Claim Status Inquiry | Insurance Processing | 86.9% | 13.1% | 0.9% | $0.028 | 2.4s | GPT-4o-mini | Good |
| ICD-10 Code Validation | Clinical Documentation | 85.3% | 14.7% | 1.4% | $0.039 | 4.1s | Fine-tuned v1.8 | Good |
| Denial Letter Analysis | Insurance Processing | 82.7% | 17.3% | 1.6% | $0.051 | 5.2s | GPT-4o | Good |
| Patient Eligibility Check | Insurance Processing | 81.2% | 18.8% | 1.2% | $0.034 | 2.9s | GPT-4o-mini | Good |
| Medical Record Summarization | Clinical Documentation | 79.4% | 20.6% | 1.8% | $0.067 | 6.8s | GPT-4o | Needs Attention |
| Referral Authorization | Clinical Documentation | 76.8% | 23.2% | 2.1% | $0.058 | 5.6s | GPT-4o | Needs Attention |
| Appeal Letter Drafting | Insurance Processing | 74.3% | 25.7% | 2.3% | $0.072 | 7.1s | GPT-4o | Needs Attention |
| Chart Review QA | Quality Assurance | 72.1% | 27.9% | 2.4% | $0.063 | 6.3s | GPT-4o | Needs Attention |
| Contract Language Extraction | Payor Relations | 71.4% | 28.6% | 2.7% | $0.081 | 8.2s | GPT-4o | Needs Attention |
| Reg Compliance Screening | Quality Assurance | 68.7% | 31.3% | 3.1% | $0.089 | 9.4s | GPT-4o base | Critical |
| Multi-Jurisdiction Coding | Clinical Documentation | 67.2% | 32.8% | 2.9% | $0.094 | 10.1s | GPT-4o base | Critical |
Prior Auth Extraction workflow • Avg breakdown by stage
Human-in-the-loop backlog
% of total monthly token spend
Performance delta: Fine-tuned v2.1 vs GPT-4o base
Investment vs savings analysis
Qualification criteria for regulated processing
Priority optimization initiatives
Infrastructure & monitoring