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Claims processing


Whether it is healthcare or other insurance, claims processing is critical to these organizations’ success. Yet it is a time-consuming, highly manual, and frustrating process for customers. Claim processing can take several days as agents carefully extract document data and verify the information from multiple sources, including police reports, medical reports, licenses, photographs, etc.

However, by implementing automation, insurers can optimize claims processing workflows, including claims intake, assessment, and settlements, minimizing frustration with minimal effort.

Let’s look at paper claims intake, for example. Paper intake is an outdated and unnecessarily error-prone process. In a paper claims scenario, insurance agents must receive, scan, and manually enter the information they receive. Then they must double-check for mistakes such as spelling, dates, and duplicate data before beginning the investigative phase. This simply won’t cut it for today’s claims load. Insurers need another way to reduce manual work and process twice the claims with the same number of employees.

qBotica’s DoqumentAI can help by automatically scanning paper claims, classifying them into types, extracting key data points, and pushing the data into the core claims systems. With this data capture software, insurers can reduce processing time from days to hours or even minutes while preventing mistakes and improving customer satisfaction.
A human message can be scanned and understood by the platform’s natural language processors (NLPs), which can then automatically respond to it or redirect it to the appropriate department.

With DoqumentAI, for instance, it may ascertain the purpose of a message sent with a “change of address” request from a client and then route it to the proper division. With a more sophisticated option, DoqumentAI can then retrieve the pertinent data and instantly map it to the necessary field in the company’s database. Changes of this nature can be automated in an unsupervised manner or manually evaluated and automated by the user.

Industry: Insurance and Healthcare