ARIS: The Claims Manager
Your AI Virtual Employee for Health Claims Adjudication. ARIS delivers fully compliant, audit-ready claim decisions in real-time with zero-touch processing.
What ARIS Can Do for You
AI in health insurance claims streamlines every step of your workflow. ARIS will assist with automating adjudication, ensuring document quality, and enriching data for faster, more accurate settlements.
Automated Adjudication
Leverage our AI Virtual Employee to instantly apply policy rules, member validations and benefit limits-eliminating manual reviews and reducing turnaround times.
- Automated Adjudication
- Claim Admissibility
- Medical Investigation Analysis
- Medical Adjudication
- Tariff Validation
- Financial Adjudication
- Pending Requirement Management
Document & Quality Assessment
Use advanced OCR and natural-language processing to extract, validate and standardize claim documents-ensuring completeness and compliance at scale.
- Data Extraction
- Document Classification
- Document Tagging
- Corrections
- Data Validation & Verification
- Cross validation across documents
- Pending Requirement Management
Enrichment, Verification & Validation
Automatically cross-check provider credentials using AI in health insurance claims, enriching claims with external data sources to detect errors and potential fraud.
- Validation of documents & processes
- Insurance Bureau Integration
- 3rd party sources Integration
- Custom Integrations
- Fraud Detection & Risk Scoring
- Data Quality & Consistency Checks
- Regulatory & Compliance Validation
Discover ARIS's Feature Suite
Our AI Virtual Employee is an end-to-end, AI-powered claims engine that automates eligibility checks, clinical validation and financial settlement - scalable, auditable and configurable.
Admissibility Checks
Instant Policy eligibility, member & waiting-period validations and network restrictions – with a real-time audit trail for compliance
- Policy, member and benefits validation
- Underwriting exclusion and waiting period
- Hospital validation (blacklist)
Medical Adjudication
AI in health insurance claims assists with discharge summary analysis and reasoning chains that enforce clinical guidelines and validate length of stay consistently.
- Establish reasoning chain
- Leverage discharge summary
- Length of stay validation
Financial Adjudication
Automated calculation of payables, enforcement of exclusions & tariffs, plus co-payment reconciliation with detailed reporting.
- Payable amount calculation
- Exclusions & tariff validation
- Deductions & co-payment calculation
Ready to Transform Claims Processing?
See how AI Virtual Employee, ARIS can eliminate manual work, slash costs, and bring instant scalability to your operations.
Why Hire Me?
ARIS, one of the AI Virtual Employees in the LiteCone family delivers end-to-end compliance with real-time audit trails and rules, automates 80% of routine adjudication with zero-touch efficiency, and scales on a cloud-native platform. Rapid integration accelerates settlements, reduces costs, and frees the team for strategic priorities.
