Digital Transformation: Impact of Claim Adjudication on Financial Stability and Operational Efficiency of Health Services Providers

Shreekant Mandvikar, Alekhya Achanta

Abstract: Process automation and artificial intelligence are considered as two of the most important fields for the prediction in any business now a days. The work focuses on the amount of insurance claims that are made by the clients of the healthcare services providers. Moreover, the study identifies the address impact of claims adjudication on financial stability and operational efficiency of the healthcare service providers. An extensive review of the state-of-the-art literature has been conducted which reveals that automation of the claim processing decision-making process in the insurance business by integrating AI technologies is crucial. Hence it is required to integrate AI process automation into the insurance claim procedure for policyholders in order to achieve high operational efficiency.

Keywords: Process automation, AI, Insurance Claims, Adjudication, Financial Stability, Operational Efficiency

How to Cite?: Shreekant Mandvikar, Alekhya Achanta, "Digital Transformation: Impact of Claim Adjudication on Financial Stability and Operational Efficiency of Health Services Providers", Volume 13 Issue 1, January 2024, International Journal of Science and Research (IJSR), Pages: 916-919, https://www.ijsr.net/getabstract.php?paperid=SR24111084444, DOI: https://dx.doi.org/10.21275/SR24111084444