AI-driven healthtech starts here.
Meet Predictal.
Our integrated solutions provide end-to-end service offerings across front, middle, and back office functions. Whether you need standalone solutions or the full breadth of our ecosystem, enGen drives results.
Our award-winning clinical solution is an AI-powered application focused on Utilization, Case, Disease, Appeals and Grievances Management, and Auto Authorizations.
Choose individual modules or integrate the full solution to maximize results.
- 2024 KLAS Points of Light award
- 2024 Pegasystems Innovation award winner
- NCQA Pre-Validated to support Health Plan Accreditation
A solution you can trust.
We’re not only SOC 2 certified, we also meet all five trust services criteria (TSC) of security, availability, confidentiality, processing integrity, and privacy.
Proven outcomes.
Healthcare doesn’t have to be an unbalanced, zero-sum game. Predictal opens the door to a win-win-win experience for clinicians, administrators, and the people they serve.
We’ve helped our clients achieve:
- ~50% increase in RN and MD cases per day
- Reduced admin spend by 7%—while increasing productivity by 2.5x
- Over 70% decrease in average cost per authorization
- ~25% boost to real-time decisions through digital authorizations
- 24% reduction in unnecessary Emergency Department use in last 2 years
- Turnaround time decreased by ~80%
* These results are examples from various clients; individual outcomes may vary.
Whole-person care management
Predictal™ is a configurable solution including Utilization, Case, Disease, and Grievances Management and Auto Authorization Hub (AAH, UM, CM/DM, AGM). Choose individual modules or integrate the full solution.
Four care management modules—one integrated solution.
Authorization Automation Hub
Use AI to examine, identify, and approve claims to increase authorization rates. Our comprehensive toolkit of intelligently automated workflows, current regulation guidelines, and self-service configuration is designed to alleviate administrative burden, achieve 'Auth by Exception' targets, and obtain determinations within seconds. We improve the provider experience with capabilities such as Gold Carding, vendor interoperability, routing to delegates, and authorization-required automation to expedite approvals.
Utilization Management
Our Utilization Management capability delivers advanced medical evaluations using near real-time member/patient data, multi-channel communication, and updated medical policies and guidelines. Prevent overtreatment costs and increase speed-to-market in a dynamic legislative environment, all while providing real-time communications to members and providers. With the most urgent and costly cases prioritized, and clinical criteria integrated within our system, your staff can work at the top of their licenses.
Case and Disease Management
Engage more members with no staffing increase. Designed and used by experienced clinicians, Predictal’s Case and Disease Management fosters meaningful, low-friction engagement between payers, members, and care management teams. Create configurable 360-degree member/patient profiles through AI-driven analysis by leveraging our proprietary advanced identification and stratification analytics. Your case and disease managers can work together to deliver personalized experiences. NCQA Pre-Validated to support Health Plan Accreditation.
Appeals and Grievances Management
Our solution’s flexible configuration helps payers adapt to changing regulations with intuitive self-service capabilities, streamlined documentation processes, and robust auditing standards. Reduce resolution and response times through user-friendly AI-powered workflows and real-time comprehensive reporting.
