Case Study: a leading national healthcare provider achieves 98% claims accuracy with 10Pearls automated claims matching

Leading National Healthcare Provider boosts claims accuracy to 98% with 10Pearls

The customer, a leading national healthcare provider, faced significant challenges with its legacy claims system, which struggled to accurately match services rendered to prior authorizations. This led to payment errors and administrative inefficiencies. To overcome this, 10Pearls developed a new automated claims matching system.

10Pearls built a solution leveraging the Appian platform to cross-match claims against prior authorizations, accurately determining whether a claim should be paid. This system increased claims processing accuracy to 98% and achieved $17 million in savings within just four months by reducing inefficiencies and incorrect payments.