Bill Review Automation for Healthcare FinTech
1 mins read
Overview
The client is a leading healthcare payment company with over 1500 employees. They had an acute need to streamline their claims process for financial optimization.
Challenges
- Automatic processing of healthcare claims submitted in non-standard formats
- Aim was to replace existing 3rd party OCR Bill review system with a new product owned by the client.
- MVP Scope: Train the product on 800+ unique claim formats
Solutions
The MVP included features to upload documents, review & edit the extraction, assign denial reasons to individual line items, export the output, summary view by Rev Code and user access management.
Technology Stack
- Azure Forms Analyzer
- Azure Functions
- Azure Web APIs
- ReactJS Web Application
Key Achievements
- Team Size: 8 (1 PM/BA, 4 Developers, 3 QA)
- Timeline: Ideation to MVP in 9 months
- Metrics: Achieved 85% accuracy at a field-level
- High accuracy with challenging data objects such as tables
