Insurance claims, run by AI

Claims from every channel — direct claims, hospital guarantees, healthcare providers, the customer app — land in one list. Filter by unit, partner, source, status and SLA; the AI badge shows which claims AI has analysed.

Upload a document set: AI OCR classifies each document and extracts every field with a confidence score; fields to review are counted right in the list, and the intake record opens automatically once reading is done.

The claims handler’s desk: each claim moves through 7 stages — AI-ready policy, documents, intake, AI analysis, review, assessment, submission. The AI recommendation and proposed payout sit on the claim for the handler to accept or reject.

Assessment claims by status — awaiting intake, in progress, awaiting approval, sent to accounting — with SLA. The amount recorded is computed by the system formula from the policy benefits.

Guarantee requests from healthcare providers are handled on the same platform: source claim status, insurance plan and SLA warnings for each request.

Open claims at each stage — intake, guarantee, calculation, approval, payment — with monthly volume and reserves, backlog age and claims over 14 days; filter by partner, branch and period.

Health policies by partner and issuing branch: issue date, cover period, insured count, premium and approval status; original policies and endorsements in one list.

Accounts, branches, partners, roles and functions at a glance; items to handle, daily email volume and shared catalogues — over 2,400 hospitals and 11,600 ICD codes.

Every email the system sends per claim — intake notices, submissions… — with delivery status, retries, recipients and timeline; every view of the content is logged.

Each partner gets its own identity: logo, colours, type, layout and sign-in page; export / import the setup to move it between environments.

Profile, security, appearance, default filters and notifications for each user.