Health Insurance Claims

Challenge

One of our client in the health industry processed more than a million insurance claims yearly. The claims and insurance processing are led by a large workforce that costed roughly 1.5 million annually. The entire process is rule based and we found that this process is a perfect candidate for automation.

Solution

Our solution for this problem is easy with latest technologies of AI BOTs. We develop auto BOTs that could process all the claims and learn the reasons for insurance denials and make correction to the rules and algorithms with each denial of claims.

Results

• FTE reduced to 20% and up to 80% reduction in manual efforts
• Reduced annual cost by 70% with the deployment of SmartView AI BOTS
• 100% accuracy with faster processing speed
• 95% reduction in denial of claims within the first 3 months
• Huge cost savings and ROI
• Completely automated with no manual intervention

Similar Posts