Problems faced by the customer

A Top 5 U.S. Health Plan was struggling with rising pended claim volumes and increasing complexity. Their existing approach lacked scalability, delivered inconsistent accuracy, and failed to generate actionable insights—resulting in persistent inefficiencies, delays, errors, and escalating administrative costs.

• High administrative cost burden:​ Attributed to manual claim resolutions​ $300 million in administrative spend​​
• Processing delays: Average turnaround times stretch from ​3-45 days leading to provider friction and interest payments.​​