Over the past few days, I’ve been exploring how automation and AI can simplify traditional health claims processing.
This Proof of Concept showcases a seamless, end-to-end workflow that connects email-based claim submissions to automated validation and AI-powered decision-making in the Workbench.
The Flow
Email submission with claim documents triggers data extraction via AI Hub
Extracted data is structured and pushed into Reels, automatically creating a case
Health eligibility and fraud checks run through AI-driven rules
Assessors view recommendations, review AI results, and take decisions — all within Workbench
The POC demonstrates both Happy and Knockout scenarios — showcasing how automation simplifies complex claim handling, improves turnaround time, and enhances accuracy.