Case Study: Asociación Chilena de Seguridad achieves 100x faster insurance claims coding with Microsoft Azure Machine Learning

Chilean nonprofit uses machine learning to process insurance claims 100 times faster

Asociación Chilena de Seguridad (ACHS), a Chilean nonprofit providing workers' compensation and risk prevention services, faced a massive backlog of 250,000 insurance claims. Their manual processing system could only handle 3,200 claims per month against an incoming volume of 20,000, putting them in violation of federal reporting deadlines. They partnered with Microsoft and its partner, Metric Arts, to implement a solution using Microsoft Azure Machine Learning and Azure SQL Database.

The solution automated the claims coding process. Microsoft Azure Machine Learning was trained on historical data to classify claims, achieving a higher accuracy rate than human coders. This allowed ACHS to process claims 100 times faster, eliminating the entire backlog within three weeks and enabling them to easily manage their monthly workload. The vendor, Microsoft, provided the technology that not only increased efficiency but also resulted in ACHS achieving the highest accuracy rating of any such agency in Chile.

Asociación Chilena de Seguridad

Camila Diaz

Health Complaints Qualifier