About Smart Claims Assistant:
A specialized workflow agent that assists claims teams in automating review, verification, and fraud detection across health, insurance, and benefits domains.

How This Works:

• Auto-Triage Claims: AI pre-screens claims for completeness and eligibility, reducing manual review.

• LLM-Powered Review: Analyze claim notes, attachments, and historical outcomes using secure hybrid LLMs.

• Fraud Pattern Detection: Cross-checks against internal DBs and third-party data to detect anomalies.

• RAG + Policy Matching: Uses secure retrieval to validate claims against policy documentation.

• Learning Feedback Loop: Continuously improves via human-in-the-loop corrections

Getting Started:
Deploy in your cloud, connect the claims database, configure fraud thresholds, and begin triaging within 5 days.