Klaimy automates the processing of health insurance claims by utilizing OCR, AI, and LLM technologies to extract and structure data from unstructured medical documents. This solution reduces operational costs by over 75% while ensuring accurate data verification and risk assessment.
Funding
Funding not disclosed
Founders
Product
Problem
Processing health insurance claims involves manually extracting and structuring data from unstructured medical documents, leading to high operational costs and potential inaccuracies. Verifying the completeness of documentation, checking policy coverage, and identifying risk factors within complex medical records are also time-consuming and error-prone.
Solution
Klaimy automates health insurance claim processing by using Optical Character Recognition (OCR), Artificial Intelligence (AI), and Large Language Models (LLMs) to extract and structure data from medical documents in various formats. The system transforms complex medical records into user-friendly summaries and identifies risk factors. Klaimy also verifies that all required documents are complete, correctly formatted, and duly signed, while ensuring policy coverage. By leveraging trusted external databases, the platform enriches and controls extracted data, leading to more efficient and accurate claims processing.
Target Audience
Klaimy is designed for insurance companies and healthcare providers seeking to streamline their health insurance claims processing, reduce operational costs, and improve data accuracy.
Features
- Data extraction and structuring from unstructured documents in any format using OCR, AI, and LLMs.
- Data enrichment and control through integration with trusted external databases.
- Automated completeness checks to verify that all required documents are submitted in the correct format and signed.
- Policy coverage verification to ensure claims align with insurance terms.
- Transformation of complex medical records into user-friendly, meaningful summaries.
- Identification of risk factors within medical records to support risk assessment.