Solution

Dociphi, Quantiphi’s AI-powered intelligent document processing platform, transformed claims processing, by eliminating the need for the reviewer to manually process each and every claim document

Dociphi seamlessly ingested and classified invoices and medical records, used proprietary best-in-class machine learning models to extract information from a wide range of document formats and templates, even from handwritten documents
Dociphi’s proprietory models intelligently mapped the Macro Guarantees and ICD codes to each claim submission based on extracted data from the documents such as diagnosis, medical test, body part, etc
With Dociphi’s smart comparison screens to compare the extracted data from docs with system data and highlight all the discrepancies, reviewers can close claims faster.

Results

Creation of a comprehensive AI-driven claims processing workflow, that supports data extraction from complex tables & hierarchical data
ML Powered ICD and Macro Guarantee mapping
Improved claims handling efficiency for accelerated claims turnaround time
Reduction of manual efforts for claim adjusters thereby reducing operational cost
91.09% accuracy achieved in document extraction for English and Italian records.
10+ Mediclaim processing rules automated through a domain-adapted AI model.
95%+ accuracy attained in disease classification, diagnosis identification, and procedure mapping using a model enriched