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Streamline Claims Processing

Automation for More Efficient, Compliant, and Fraud-Resilient Solutions

Overview
At Tungsten Automation, we recognize and address the specific challenges faced by insurance companies in claim processing. Complex processes, exacerbated by manual data recognition and disconnected systems, hinder efficient claim assessment and validation. Customer dissatisfaction is a pressing concern, driven by the demand for seamless, 24/7 service, and frustration with manual processes and difficult user interfaces. Bad and inaccessible data further compound these issues, leading to errors, longer processing times, and increased costs. Moreover, high average handling time, fueled by insufficient insurer-claimant communication, results in a 30-40% increase in claims resolution time. With Tungsten Automation, insurers can streamline processes, improve data accuracy, enhance customer satisfaction, and expedite issue resolution, ensuring optimal performance in claim processing.
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Benefits

Faster Claim Processing and Enhanced Accuracy

Significantly speed up claim processing timelines and diminish manual errors, guaranteeing more precise claim assessments.

Enhanced Fraud Detection

Leverage automated analytics on claims data to simplify the detection of fraud patterns by identifying suspicious or fraudulent claims.

Consistency and Compliance

Improved adherence to regulatory requirements and internal policies, reducing the risk of compliance-related issues.

Solution capabilities

Advanced AI/Generative AI

Simplify content recognition, extraction, decision-making, and workflow design with GenAI.

Business Rules Engine

Define and apply business rules to automate task completion and drive smarter decision-making.

Case Management

Manage multiple documents and content and associated tasks more efficiently.

Task Automation

Gather, compare and complete data comparison tasks for faster, more accurate review.

Data Validation

Validate extracted data for precise accuracy and consistency.

Continuous Monitoring

Provide unrivaled fraud detection with real-time process monitoring and alerts.

FAQ
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Yes, the solution provides support for scanning, extracting data from, and processing common document types like ID cards, forms, PDFs, images, and more
Yes, the solution offers robust certified integrations with leading insurance platforms like Guidewire and Duck Creek
Yes, the solution can readily manage insurer needs involving very high document loads, avoiding choke points through always-on or event-based scalability
The solution can integrate with multiple off the shelf products in the market providing similar capabilities 

Solution leverage auto-scaling capabilities to rapidly spin up cloud infrastructure needed to handle influxes in claim volume from major events within hours 

Yes, the solution includes a pre-packaged bundle of metrics, dashboards and reports. The solution also allows organizations to create new reports and dashboards based on a library of best practices metrics, and features pre-built content for capture-based processes 

Tungsten Automation implement rigorous enterprise-grade security capabilities covering data security and user access protocols spanning
Yes, the solution provides integrated tools which empowers developers and business users to create their own AI bots for desired automation use cases without dependency on vendors