Automation of insurance claims processing

Assignment
Automatic processing of insurance claims to reduce TAT and decrease cost of processing (no increase in personnel).

Our approach
We cover the following steps of the process
Verify data from documentation (date of injury, name, birth id, etc..)
Create case history (first visit, medical checks, end of treatment)
Classify diagnosis

We had to solve some challenges like:

  • Vaguely specified date in medical report
  • Determine start and end of each medical report (for having more reports on one page)

Deployed product: Agentic system

Result
diagnosis classification reliability over 97%
document data extraction reliability 70-97%