Healthcare & Life Sciences

70,000 Claims a Month, By Hand

Medical Device Manufacturer

Healthcare & Life Sciences | Regulated healthcare operations | High-volume manual claims processing with compliance requirements | ~70,000 claims per month
70,000 Claims a Month, By Hand

Summary

Seventy thousand claims arrived each month typed, handwritten, and misaligned. Variation broke every rules-based approach. Generative AI paired with human review created a path through that complexity without trading compliance for speed.

Moment

Around 70,000 claims per month were processed manually. Forms arrived typed, handwritten, and misaligned, and variation broke traditional automation.

Tension

Stay manual to protect compliance, or test generative AI in a disciplined, auditable way.

Risk

Over-automation could raise error rates and regulatory exposure. Moving too cautiously would lock in cycle time and cost.

Execution

We paired AI extraction with human review and confidence thresholds. Automation handled high-confidence cases and routed edge cases to reviewers with clear audit trails. Implementation stayed forward-deployed—inside regulated operations, with human review and control boundaries defined before scale.

Outcome

~70,000 claims/month processed; manual effort reduction path with explicit AI boundaries

Continuity

What had to stay stable during the change

Compliance audit trails and human review for edge cases had to remain intact during automation rollout.

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