Fixing Health Insurance Capture with AI and API

Insurance is a near necessity to living in modern America. Healthcare bills, uninsured, are going to be almost unthinkable to pay off for most families. It may be surprising to hear then that 27% of denials are coming from errors in patient processing and registration. In other words, nearing a third of all denials are due to simple and avoidable errors.

It’s worthwhile then to understand where these errors are happening. There are four main contributors and factors. The first is a lack of awareness of insurance information and insurance expertise. While insurance cards can have a plethora of information, they often don’t have everything needed for a claim. Lacking information means claims will be made improperly and possibly denied.

The second is not knowing where to submit the insurance claim. Many insurance companies today will have state or region specific localities to submit to. Submitting to the wrong locality can lead to denial or at the very least redirection. The third contributor is simple human misinput. When manually putting in information it’s unfortunately common to make an error somewhere along the way.

And the fourth contributor is when card readers are used which don’t recognize insurance information. This isn’t to say that card readers are making mistakes. Rather, any information missing on an insurance card won’t be filled in by the reader. Luckily AI powered card readers have started to alleviate these issues. 

These new AI readers are trained on health insurance insurance card capture with AI and API for payers and plans. This gives them the unique ability of recognizing information not directly on the card. These new readers also help to alleviate the other three issues. They’re completely automated, can help with submission, and again will recognize all the information. Of course AI card readers aren’t necessary to alleviate these issues, but they’re a new and accessible solution. Accessibility is particularly important when a lot of these errors are due to a simple lack of information.