← All selected workHealthcare billing · Delivered project Representative interfaceSample data Explore AI workflows for medical billing
Claims backlog
A three-day backlog became a same-day routine.
The bottleneck
Claims sat for three days before anyone could work through them.
What changed
Documents are read and prepared on arrival. Only exceptions reach a person.
Inside the implementation
Document intake uses OCR and field extraction, validation rules for payer-specific requirements, and a review queue for anything the rules cannot confirm. Access is limited to the billing folder. Every automated action is recorded for audit.
CLAIMS OPERATIONSException review queue
Updated now18 prepared3 need review1 rule changed
ClaimCheckStatus
CLM-0842Fields validatedReady
CLM-0847Prior auth missingReview
CLM-0851Code conflicts with ruleReview
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