Streamlining insurance lifecycles with intelligent extraction of member IDS, CPT codes, and ICD-10 medical billing data.

The Challenge

A European clinical laboratory network was struggling with a 15% rejection rate on insurance claims due to manual data entry errors from "Super Bills" and Insurance Cards. The billing cycle was averaging 45 days.

The Solution: Healthcare Workflow Automation

We implemented a HIPAA-compliant (and GDPR-ready) automation suite that handles:

  1. Insurance Card OCR: Instant extraction of member IDs, group numbers, and plan types from various European providers.
  2. Super Bill Digitization: Mapping CPT codes and ICD-10 codes from handwriting or semi-structured print to the central billing system.
  3. Real-time Eligibility: Instant verification of insurance status before the patient leaves the clinic.

The Result

  • Rejection Rate: Slashed from 15% to < 2.1%.
  • Billing Cycle: Reduced from 45 days to 7 days.
  • Efficiency: Staff saved 40 hours per week on data entry per clinic.

Technical Stack

  • Extraction: Document AI (Vertex AI)
  • Verification: Custom Pydantic AI Validation layers
  • Compliance: End-to-end encrypted processing pipelines