Case Study: Major US Healthcare Insurer achieves 29% reduction in failed claims and $14M annual savings with Splunk

How Splunk Software Helps to Manage and Control Both Processes and Costs

A major U.S. healthcare insurer discovered its Electronic Data Interchange (EDI) claims automation was underperforming: roughly 14% of electronic claims failed on first pass (≈1.5M failures/year), creating hundreds of thousands of hours of manual rework, limited end‑to‑end visibility for IT, slow troubleshooting, and costly, time‑consuming reporting that negated the expected benefits of automation.

The insurer deployed Splunk Enterprise to capture and correlate logs across WebSphere, MQ, IIS, Sterling and Facets, then built real‑time dashboards and automated compliance reports. This gave teams rapid root‑cause visibility, reduced error rates and streamlined reporting — results include an expected 29% reduction in failed claims, roughly 200–210K fewer manual hours, about $14M in annual savings, plus approximately $650K/year in troubleshooting savings and lower reporting/tooling costs.