Streamlining Claims Processing


The largest pharmacy chain in the United States by number of locations engaged Quantilus to streamline their claims processing. The chain was struggling with the increasing amount of data its claims processing system generated. With a large volume of claims every day, the pharmacy chain’s existing data pipeline struggled to keep up with the demand. The system required manual intervention, and it was not scalable to handle the growing volume of data. 


The pharmacy chain was facing the following challenges with its existing claims processing data pipeline: 

  • The existing data pipeline was slow and unable to handle the growing volume of claims data. 
  • The process required manual intervention, which was time-consuming and error-prone. 
  • The pharmacy chain lacked the ability to perform advanced analytics on the claims data due to the limitations of the existing data pipeline. 


The pharmacy chain partnered with our team of experts in ML and Big Data to design and implement a claims processing data pipeline orchestration system. The new system automated the entire claims processing workflow, from data ingestion to data cleaning, transformation, and loading. The system also included an AI-powered claims validation module, which automatically detected errors and anomalies in the claims data, reducing the need for manual intervention. 


The key features of the new system included: 

  • Automated claims processing workflow. 
  • ML-powered claims validation module. 
  • Scalable and flexible data pipeline architecture. 


The new claims processing data pipeline orchestration system provided the following benefits to the pharmacy chain: 

  • Improved efficiency and accuracy of claims processing, resulting in faster turnaround times for customers. 
  • Increased data pipeline scalability and flexibility, enabling the pharmacy chain to handle larger volumes of claims data. 
  • Reduced manual intervention in the claims processing workflow, resulting in fewer errors and reduced labor costs. 
  • Enhanced analytics capabilities, enabling the pharmacy chain to gain insights from the claims data and improve its business operations. 


The new claims processing data pipeline orchestration system helped the pharmacy chain to streamline its claims processing workflow, reduce errors, and gain valuable insights from its data. 



How AI Empowers AR & VR for Business

Wednesday, June 19, 2024

12:00 PM ET •  9:00 AM PT