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Straight-Through Claims Adjudication
Enable automatic adjudication of routine claims with AI-powered decision support and compliance validation.
How It Works
- 1
Eligibility Check
Verify policy status, coverage, and deductibles automatically
- 2
Documentation Review
AI analyzes submitted documentation for completeness
- 3
Decision Engine
Rules-based engine applies policy terms and calculates payment
- 4
Compliance Validation
Ensure all regulatory requirements are met
- 5
Payment Processing
Automatic payment initiation for approved claims
Benefits
- Process 70% of claims without human intervention
- Reduce average claims cycle time by 60%
- Ensure consistent application of policy rules
- Improve claimant satisfaction with faster payments
- Reduce operational costs per claim
- Maintain complete audit trail for compliance
Key Metrics
70%
Straight-through rate
60%
Faster cycle time
45%
Cost reduction
98%
Accuracy rate
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Next step
See automated claims adjudication automated on your systems
Prove the workflow in a 10-Day Sprint — with a clear go / no-go decision.