Processing time management
Operational inefficiencies
Critical information processing
Fraud verification
Missing and incomplete information
Reduced processing time
Improved efficiency
Enhanced customer experience
Empowered human resources
Human eye accuracy
Handling peak volumes
On uploading the claim file, document classification is performed automatically and responds to any missing document required for complete processing
Any changes related to nomenclature is handled using ML based models which detects and maps the extraction based on the similarity of the data processed
Extensive claim processing requires further intelligence in terms of category/sub category mapping or payable/non payable mapping which is enabled by integrating 3rd party or bring your own data sources
Medical summary is critical in processing and based on the information extracted automatic routing of the claim cases happens without any manual intervention
Due to high competition in terms of various insurance products, custom rules based on terms and conditions of various products have been embedded for efficient claim processing
To perform faster claim processing, unified view of claim is produced to drive the decision making faster