Case Study: a leading insurance provider reduces medical overbilling by $10M with Protecto

a leading insurance provider cuts medical overbilling by $10M with Protecto

A leading insurance provider faced the challenge of medical billing errors, such as upcoding and unbundling, which cost the U.S. healthcare system over $200 billion annually. They needed a solution to accurately detect these errors while ensuring strict compliance and protecting sensitive patient data privacy. They partnered with Protecto to implement its secure AI solution for this task.

Protecto implemented a privacy-preserving solution for the customer that involved creating a ground truth dataset, masking sensitive PHI data, and using an AI-powered similarity search to identify billing errors. This resulted in a projected $10 million in annual savings, a 50% reduction in billing errors, and zero data privacy violations, all while speeding up claims processing by 20%.