A specialty clinic network
Insurance claims rejected on formatting errors nobody caught until the money didn't arrive.
- Sector
- Healthcare services
- Duration
- 16 weeks
- Scope
- Digital transformation · Applied AI
The problem
Claims were assembled by hand from a practice management system, a scanner folder, and the doctor's notes. Roughly a fifth came back rejected — most for missing documents or codes that didn't match the procedure. Each rejection cost about three weeks and a staff afternoon to resubmit.
What we built
We digitised the claim pack end to end, then added extraction over the scanned documents so codes and attachments are matched before submission rather than after rejection. A validation step flags mismatches to a human, who approves or corrects. Everything writes back to the practice system with an audit trail.
The numbers
- Claim rejection rate
- 21% → 6%
- Average time to payment
- −14 days
- Clinics live
- 8
- Model outputs human-reviewed
- 100%
Example engagements — representative of our work, not client-attributed.
Your situation is different. The method isn't.
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