Case Study: Insurance Claims Clearing House achieves $600K savings and faster claims processing with Roots Automation

$600k In Cost Savings On CMS-1500 Automation For A Care Coordination Company

Insurance Claims Clearing House, a healthcare insurance claims clearing house, faced significant challenges in processing a high volume of CMS-1500 medical claims. A surge in workload from expansion into new states led to missed deadlines, employee burnout, and high error rates. To avoid the cost of hiring additional staff, the company turned to Roots Automation and its AI Agent solution for claims indexing and data extraction.

Roots Automation implemented an AI Agent to automatically read, extract data from, and process both electronic and paper claim forms. The solution was trained to handle inconsistently completed and handwritten documents, with a human-in-the-loop system for exceptions. This allowed Roots to process 100% of month-end claims by the deadline, handling over 80% of claims automatically. The customer achieved a 256% ROI within seven months, saving $600,000 in payroll costs and freeing up staff for more valuable work.