Minutes, not days. AI handles intake, validation, adjudication, and payment. Learns your business rules. Runs your edge cases. 80% faster processing. 70% lower costs. Live in 7 weeks.
Outcomes measured after deployment
Cycle time drops from days to hours. Routine claims processed instantly. Complex cases flagged with full context for adjusters.
Staff moves from manual processing to customer service and fraud detection. The machine handles volume. People handle judgment.
Coverage rules applied consistently. Every time. No missed exclusions. No misread policy terms. No fatigue errors.
Every step in the claims lifecycle, handled by AI agents
Email, portal, mobile, API. Data extracted from forms, photos, and supporting docs automatically. No manual re-entry.
Coverage verified. Policy limits checked. Provider credentials validated. Eligibility confirmed. All before adjudication starts.
Business rules, medical necessity, pricing guidelines - applied automatically. Complex cases routed to adjusters with AI recommendations attached.
Suspicious patterns, duplicate claims, billing anomalies - caught before payment. High-risk claims flagged for investigation.
Automated status updates. Missing info requested proactively. Self-service tracking. Claimants stay informed without calling in.
Approved claims go straight to payment. EOBs generated. Payment systems integrated. No manual handoff.
Running in production across insurance and healthcare
FNOL processed. Damage assessed from photos. Repairs estimated. Payments approved in hours, not weeks. Auto, home, and commercial property.
Medical, dental, pharmacy. Benefits verified. Coding applied. Duplicates caught. Adjudicated against plan rules. Straight-through processing.
Injury reporting, employer coverage validation, causation assessment, treatment authorization. AI handles the workflow. Adjusters handle the decisions.
Documentation gathered. Policy conditions validated. Benefit determinations processed. Sensitive claims handled with accuracy and speed.
Traditional claims systems take 12-18 months. Forward Deployed Engineers build and deploy in weeks - then stay embedded to make sure it holds.
Based on typical enterprise deployment
Built for the Monday morning backlog and the Friday afternoon surge. Production AI that holds.