International Journal of Science and Research (IJSR)

International Journal of Science and Research (IJSR)
Call for Papers | Fully Refereed | Open Access | Double Blind Peer Reviewed

ISSN: 2319-7064


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Research Paper | Computer Science and Information Technology | United States of America | Volume 13 Issue 1, January 2024


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

Shreekant Mandvikar [4] | Alekhya Achanta [6]


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


Edition: Volume 13 Issue 1, January 2024,


Pages: 916 - 919


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