AI’s Healthcare Claim System Improvements

The healthcare insurance industry is currently not operating at its highest capacity. A lot of claims are being denied for reasons that are not due to coverage limitations. In fact, a sizable amount of denied claims are purely due to errors that are made during the patient registration process, which amount to $71 billion per year. A lot of these errors are due to the provider’s lengthy requirements for submitting accurate information, and the human mistakes that arise as a result of these requirements. For example, insurance companies such as Medicare, Tricare, and BlueCross BlueShield have stringent locality selection requisites. Picking the wrong one can result in an instant denial of the claims. 

AI insurance card capture  might be the solution to this industry’s woes. It offers promises of heightened accuracy and efficiency, due to its thorough training on thousands of data sets. This allows it to identify information such as claims payerID, subscriberID, and plan type in as little as five seconds. This is a massive improvement from the five to fifteen seconds that it takes for a human to process and validate the information. In addition, AI produces more accurate results, which can reduce the expenditure ($25 per claim) for reworking an inaccurate claim submission.

The Smarter Way to Capture, Verify, and Process Insurance with an AI-Powered Solution
Source: OrbitHC