Case Study: a large healthcare company achieves faster claim settlements and higher reimbursements with Innoflexion’s GenAI billing solution

Large Healthcare Company - Customer Case Study

The large healthcare company faced significant inefficiencies in its billing process, particularly with claim disputes under the No Surprises Act. Its manual, error-prone Independent Dispute Resolution (IDR) journey led to delayed reimbursements and high operational costs. The company partnered with Innoflexion to implement a GenAI-powered solution for healthcare reimbursement automation.

Innoflexion's solution used a combination of LLM, SLM, and machine learning to automate the IDR process end-to-end, from data collection to automated claims resubmission. This resulted in a 95% reduction in manual dispute work and a 50% reduction in operational costs. The AI-driven system also ensured 95% accuracy in brief generation and provided streamlined compliance, leading to faster reimbursements and significantly improved cash flow for the provider.