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Health Claim Document Automation

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Challenge

Imagine you had a car crash and broke a foot. An ambulance comes to the rescue and you are brought to the hospital. There, you receive medical treatment including scans. When you are ready to go home, you call a taxi. Finally, you will have to take medicine for a couple of weeks to help the recovery.

This journey will generate many invoices and other documents that you will have to send to your insurance to get reimbursed.

That's when problems may start as you might have to wait for a few weeks before getting an answer back from your insurance. The problem is that insurance companies receive millions of emails and documents per year from both customers and brokers, that require armies of people to process. This overload of work is hurting insurers:

  • as claim settlement processes are slowed down,
  • representing an increase operational costs,
  • favouring encoding erros
  • and that could also be a source of de-motivation for employees.

In the end, you get frustrated and feel left out or not considered fairly. This is a very important moment for an insurance company. A moment where they need to make a difference.

Solution

To solve this problem, Sagacify integrates Skwiz. Skwiz is an AI-based solution that automates the processing of emails and documents. With Skwiz, claims reimbursement can be accelerated by automatically processing the emails and documents instigating the process.

Skwiz is capable of automating most tasks related to document processing in companies, on a wide (and growing) number of document types: 

  • Document splitting
  • Document type classification
  • Automatic extraction of specific fields in documents
  • Extraction of line items in tables
  • and more

To achieve this, Skwiz relies on advanced AI models specially designed to automatically extract and structure all the data contained in invoices, receipts, and other semi-structured documents, without the need for templates. Our unique model uses a combination of NLP and computer vision to understand the document semantically, but also spatially, like a human would. Today, Skwiz is the central piece of the administrative optimization initiative in several large companies, in various sectors such as insurance, banks, financial software, but also logistics or the public sector.

These capabilities, used alone, or in conjunction with other solutions, like Mailbot, Sagacify’s email processing solution, means that Skwiz can be used as a central tool for automating most of the incoming documents processing of an insurance company, without the need to rely on templates or documents models that are painful to maintain. 

For more information, you can contact the Skwiz team through their website : www.skwiz.ai

Results

  • more than 250K documents per year treated
  • 8 documents types currently supported
  • 80% of documents reached a full automation rate
  • Reduction of 2,5 full time equivalent resources

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