CONNECT WITH US
AI & Deeptech

AI & Deeptech

Reducing medical claims review time with AI on AWS: The EXL Medical IDP solution

AWS Machine Learning logo

Published on

Add as a preferred source on Google
Reducing medical claims review time with AI on AWS: The EXL Medical IDP solution

Insurance claims adjusters spend over 100 minutes per case manually reviewing medical records. The EXL AI-powered Medical intelligent document processing (IDP) solution, built on AWS, transforms this process. It combines IDP with domain-specific large language models (LLMs) to extract, summarize, and query medical information at enterprise scale.

In insurance claims adjudication and life underwriting, medical records are the foundation of every decision. Claim adjusters and underwriters must review these records, often several hundred pages long, to assess validity, determine payouts, or make underwriting decisions.

The challenge isn’t simply volume. Medical records are unstructured, filled with specialized clinical terminology, and require the reviewer to connect disparate data points about a patient’s condition and its evolution over time. The documents themselves span dozens of types: chiropractic care notes, diagnostic tests, emergency room visits, operative reports, physician consultations, prescription drug reports, psychiatric evaluations, lab results, independent medical examination (IME) reports, and peer reviews, among others.

This review demands deep medical domain expertise, sustained concentration, and interpretive judgment. Given this complexity, the process is slow, manual, and prone to inconsistencies. Different professionals interpret the same medical data in different ways. The consequences are real: delayed claim settlements, accuracy issues in evaluations, increased indemnity costs, adverse customer experience, and heightened regulatory scrutiny.

EXL is a data analytics, AI, and digital solutions provider serving Fortune 500 organizations for over 25 years. With over 50,000 professionals globally, EXL brings deep expertise in insurance, healthcare, banking, capital markets, retail, media and communications, and energy to reimagine business models, deliver measurable outcomes, and accelerate innovation.


Source link
Related Topics:AI & Deeptech

Disclaimer

We strive to uphold the highest ethical standards in all of our reporting and coverage. We TheMorningPulse.fyi want to be transparent with our readers about any potential conflicts of interest that may arise in our work. It's possible that some of the investors we feature may have connections to other businesses, including competitors or companies we write about. However, we want to assure our readers that this will not have any impact on the integrity or impartiality of our reporting. We are committed to delivering accurate, unbiased news and information to our audience, and we will continue to uphold our ethics and principles in all of our work. Thank you for your trust and support.