Use of Artificial Intelligence for Health Insurance Claims Automation

Abstract

The research focuses on the automation of health insurance claims by using artificial intelligence, more specifically, machine learning. In today’s world, where every bit of a record collected is considered information and where every bit of this information plays a vital role in the future decisions, traditional, and manual methods of determining whether a claim made are authentic or fake, of deciding whether to accept or reject that claim in the health insurance business are no longer viable. On the other hand, artificial intelligence the ability of machines to perform equal or more than a human mind is taking over the world. Applying those abilities in place of traditional claim assessment, we get a system that is not only efficient and fast, but it also finds the trends and patterns in the data that were previously not known to exist. The motivation behind this project is to save time, be efficient, avoid tedious manual work, and most importantly human error. The implemented system will help to distinguish between absolutely deserved and undeserved health insurance claims.