About
Automatic handling software which can analyse medical documents and evaluate the insurance coverage, with the main objective of automating the settlement process and reduce the handling time of the request.
Innovation presentation
This AI-based solution combines customers’ health information, extracted from the medical documents provided, with his/her insurance coverage in order to apply settlement rules. Moreover, ICS provides a full digital process: from the customer’s request to the claim settlement. This new dedicated and automated process allows to:
o Automatically authorize service requests: when a customer has to undergo a medical procedure this solution automatically evaluates his/her coverage to understand whether the service can be authorised or not.
o Automatically settle the invoice: once the customer has been authorized and the medical clinic has dispensed the medical service, this solution, upon receiving the invoice, verifies whether everything complies with the authorization conditions and settles the amount to be paid to the clinic.
Uniqueness of the project
This solution allows the customer to easily and quickly obtain the authorization to perform the requested treatment and the clinic can receive claim settlements in a much shorter time range, improving both the experience and the engagement towards the company. Nonetheless, the project also focuses on another pillar, the ambition to favour not only the customer but also the employees, since automating steps of the process enables high operational efficiency.
