Claims Processing
Process Claims Faster with AI-Powered Adjudication
The Challenge
- • Claims backlog grows faster than staff can process
- • Manual adjudication is inconsistent across adjusters
- • EOB underpayments go undetected without systematic audit
- • Prior auth expirations cause preventable claim denials
How LasaAI Solves This
LasaAI processes claims against policy rules, tracks authorizations, and audits EOBs — with human review for edge cases and regulatory compliance.
Ready-to-Use Solutions
Claims Adjudication Engine
Process claims against policy rules and fee schedules
adjudicated_claims, denied_claims, batch_statistics
EOB Processor
Parse remittance, flag underpayments vs expected rates
payment_details, underpayments, denials
Claims Status Tracker
Track pending claims, generate prioritized follow-up queue
claims_by_age, status_summary, follow_up_queue
Prior Auth Tracker
Monitor authorizations, flag expirations, generate task list
pending_auths, expiring_soon, daily_task_list
Policy Renewal Processor
Compare renewal terms, generate client-facing summary
premium_comparison, coverage_changes, client_summary
5 solutions available in this category
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