Case Study: Expion Health boosts claims processing efficiency with UiPath

AI for Claims Reconciliation: 600% Increase in the Volume of Claims Expion Health Handles Daily

Expion Health, a healthcare cost-management company based in Gaithersburg, Maryland, needed a faster way to handle claims reconciliation and pricing. Its manual process involved logging into payer systems, pulling claims from paper or unstructured documents, and entering data by hand, which limited the team to about 75 claims per day. UiPath helped address this challenge with document processing and automation tools, including UiPath Document Understanding, AI Center, Action Center, and Computer Vision.

UiPath and its partner qBotica implemented an automated workflow that downloads claims PDFs, extracts and classifies data, routes exceptions to employees for review, and sends the validated information to Expion Health’s pricing platform. The results were significant: claims volume increased by up to 600%, productivity rose by 97%, and the company achieved a 99% claims processing success rate. In a one-month sample, Expion Health processed 4,132 claims, averaging 148 per day and peaking at 710 in a single day.

Expion Health

D.S. Suresh Kumar

Chief Transformation Officer