Insurance · Claims operations
Claims operations, run by a governed AI team.
The engine that runs healthcare RCM in production, pointed at carrier-side claims work: intake, submission, follow-up, and exception handling — every action evidenced, priced, and human-approved.
Ready to deploySame engine, same governance — waiting on a signed client, not on the tech.
Three workflows
01
Claims intake & triage
Classifies inbound claims, extracts the fields that matter, and routes the edge cases to a person instead of forcing a bad auto-decision.
02
Submission & follow-up
Prepares the submission against payer rules, tracks status, and chases the silence — with a full audit trail behind every touch.
03
Exception handling
Surfaces the claims that fall out of the happy path, explains why, and holds them at the approval gate with the evidence attached.