Insurance Claims Automation

Identify high-value fraud investigation and segment claims for automation.

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Daisy’s Claims Automation solution supports straight through processing by making autonomous fraud avoidance and adjudication decisions, minimizing human intervention, and empowering employees to focus on claims that require human intervention.

Daisy provides high-volume, low-touch claims processing

Automate and settle more claims with confidence, and flag cases that require human interaction.

  • Daisy’s claims automation system enables straight through processing so valid claims can be immediately processed without human intervention.
  • Daisy’s Theory of Risk™ informs partial-pay auto-adjudication, eliminating non-compliant claims or claim combinations.
  • Daisy identifies claims into the right segments, so the right people focus on complex claims, dramatically increasing straight through processing.
  • Increase efficiency using Daisy to automate the collection of more detailed claims information.

Increase customer satisfaction

Automate many types of claims, improve customer retention and increase operational efficiency.

  • Pay out valid claims promptly.
  • Ensure payment of legitimate claims even when more detail is needed for partial pay or secondary claims.

Increase customer satisfaction

Automate many types of claims, improve customer retention and increase operational efficiency.

  • Pay out valid claims promptly.
  • Ensure payment of legitimate claims even when more detail is needed for partial pay or secondary claims.

Release capital reserves and improve loss ratios

  • Reduce claim handling cycle times and reduce the amount of organizational capital held in reserve.
  • Daisy’s payability score maximizes the use of Robotic Process Automation (RPA).

Proven results

Improve straight through processing by more than 100%

Our global clients have increased straight through processing by more than 500%.

Automate waste and abuse claims and claim combinations

Daisy’s insurance claims automation saved a leading global health insurance company more than $5M through auto-adjudication. Our fuzzy logic aggregation rapidly identified treatment and product combinations that occur at high volume but usually go undetected.

Explore Our Other Insurance Solutions

Insurance Assessment

From fraud avoidance to increasing straight through processing, Daisy’s Insurance Assessment identifies previously uncovered value and business opportunities for your company.

Fraud Detection

Use real-time data to detect and resolve suspicious claims, and dramatically lower false-positive rates.

Underwriting

Use AI-Powered Underwriting to evaluate 100% of claims data, align prices with risk, and drive higher profits while lowering operating costs.

Loss Ratio Optimization

Find the optimal combination of pricing, underwriting, fraud avoidance, and claim processing decisions to determine the desired loss ratio.

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