Fast track health claim settlements using Marvel.ai

What our customer encountered?

Delayed medical claims settlement process due to the following challenges:

Manual validation of diverse insurance data

Scanned or native PDFs, images, emails of discharge summaries, and medical bills, comprising pages of data.
Approximately 98% of the data was unstructured.
Historical customer data scattered across documents and folders, making retrieval difficult.
Lack of granular data for analysis when needed.

Codification and verification

Manual codification and verification for each line item of the discharge summary.
Cross-referencing multiple applications added complexity to the process.

The challenges resulted in:

Data errors and fraudulent claims
Prolonged settlement timelines
Increased costs and human resources
Inefficiencies in the insurer’s operations

What our customer needed?

Automated data validation of diverse insurance data from varied sources for a faster settlement process.

The Solution

The bank implemented Marvel.ai, an AI-first, cloud-native business transformation engine, to streamline the processing of discharge summaries and medical bills.

Marvel applied advanced AI and machine learning to intelligently validate, categorize, and analyze submitted documents in seconds. This enabled faster and automated claims processing while providing actionable insights for fraud detection, process optimization, forecasting, and informed decision-making.