Applications of AI and Machine Learning for Insurers
A simple cloud service for insurers to rapidly evaluate the performance and business benefits of SMART-CLAIMS© using their own data
A successful pilot is very critical in showcasing the capabilities and benefits of SMART CLAIMS on your specific data. When you can “try before you buy”, it minimises risks to both parties.
The service is intended for insurers seeking to improve operational efficiency and cost management such as Claims Managers, Cost Containment Managers, Fraud/leakage Prevention Managers.
PRE_AUTHOURISATION or ELOG
DECLINE with justifiable reasons linked to ICD codes
SMART CLAIMS requires claims information (header, items), policy, plans and benefits.
Historical data needs to be uploaded into 2 phases:
a) Training phase – 1 year or 100K historical claims records, whichever is more.
b) Validation phase – 3 months or 10K claims records, whichever is more.