AI-optimized claims processing
Claims processing: 45-60 days → AI-optimized: 7-14 days. Automate adjudication, slash denial rates, and reduce cost per claim by 40%+.
Performance benchmarks
Where does your claims operation sit? Compare across four critical metrics.
Sources: Industry benchmarks 2024. Average denial cost: $15-30 per claim. ERISA compliance: urgent claims 72 hrs, pre-service 15 days, post-service 30 days.
What global leaders are doing
Industry examples from publicly reported initiatives — not Xamun projects. Included to illustrate what AI transformation looks like in this sector.
Leading insurers are transforming claims with AI and RPA at massive scale.
- ✓ Gen AI embedded end-to-end
- ✓ Prior auth bundling: pharmacy + medical (industry-first)
- ✓ 90 min saved per nurse per day
- ✓ 4 systems → 1 unified platform
- ✓ Extensive RPA in claims processing
- ✓ AI eligibility verification in real-time
- ✓ 150+ million claims processed annually
- ✓ Automated coverage checks
- ✓ AI reads unstructured forms → structured data
- ✓ RPA bots verify coverage in real-time
- ✓ AI monitors status, handles exceptions
- ✓ Analytics adapts logic to reduce denials
The transformation opportunity
What changes when a mid-market insurer deploys AI across claims processing.
- ✗ Processing time: 45-60 days average
- ✗ First-pass approval: 75-80%
- ✗ Denial rate: 12-18%
- ✗ Manual review: 85%+ of claims
- ✗ Cost per claim: $4-6
- ✗ Claims errors: 5-8%
- ✗ Customer inquiries: 100+ calls/day
- ✓ Processing time: 7-14 days average
- ✓ First-pass approval: 90-95%
- ✓ Denial rate: 5-8%
- ✓ Manual review: 15-20% (exceptions only)
- ✓ Cost per claim: $2.50-3.50 (40%+ reduction)
- ✓ Claims errors: <1%
- ✓ Customer inquiries: 20-30 calls/day (70%+ drop)
We build it, run it with your team — and you pay per claim processed.
No upfront CAPEX — we invest the build ourselves. Once it’s live, you pay a small toll per claim submitted and adjudicated the system processes: a small fraction of the value each one creates. A slow month means a small invoice; if it doesn’t run, you don’t pay.
We’re not a vendor shipping software into your operation. For the operation we run, we’re part of your company — in your numbers every week, paid only as they move. Where processed claims aren’t the honest measure, the Licence door applies instead: one capital fee for the bottleneck, full source delivered, final payment at done. The accountability doesn’t change, only how you pay.
How Xamun delivers this
From diagnostic to deployed system in weeks — not months.
Xamun Intelligence benchmarks your processing timelines, denial rates, first-pass approvals, and cost per claim against AI-optimized leaders. Identifies highest-value automation targets.
RPA for rule-based processing, NLP document understanding, real-time eligibility AI, denial prediction models, prior auth automation, and fraud detection — built in weeks.
50-70% faster processing in 3 months. 10-15% first-pass improvement in 6 months. 40-50% denial reduction in 6 months. 70-80% fewer customer inquiries in 3 months.
See XI run a diagnostic on your claims operations
Book a discovery call to see how your claims processing benchmarks against AI-optimized leaders — and what Xamun can build for you in weeks. No upfront cost — you pay only when the system runs.