Claims Processing Solutions

SMARTS™ Application for Insurance

Automated Insurance Claims Processing Challenges

Many claims processing solutions are still manual, requiring costly use of experienced human resources, slowing processing times, and producing inconsistent results. This can reduce customer satisfaction and retention rates while increasing processing and claim costs. As a result, many insurance firms have invested in claims processing software. However, many firms are finding that their approach to automation is too opaque, rigid, and cumbersome to manage.

This is why leading insurance firms are turning to SMARTS™ to transform their claims processing. SMARTS™ is a modern, enterprise-level, application-agnostic, decision-management platform that enables non-technical analysts and SMEs to easily automate, manage, and continuously improve business-critical decisions in daily operations, such as underwriting decisions, in a manner that is transparent, flexible, and scalable.


SMARTS™ Benefits:

  • Shorten open claim time
  • Lower claims leakage
  • Increase customer satisfaction, retention and net promoter score (NPS)
  • Continuously monitor key performance metrics
  • Leverage AI & machine learning in decision making

Future-Proof Claims Processing with SMARTS™

Claims Processing Solutions for Managing Complexity

Adjudicating claims is complex, often requiring adjudicators to access multiple tools and data sources in order to make a claims decision. SMARTS™ provides a host of tools and capabilities to empower adjudicators, business analysts, and product leaders to take back control.

  • Rules Authoring:

    SMARTS™ enables adjudicators to easily author, organize, test, and deploy claims decision models without code. Rules can be reused, speeding up the onboarding of new products, lines of business, and providers. In addition, we provide the tools that make it easy to migrate existing rules from legacy systems into SMARTS™. As a result, migration and validation of millions of rules can be completed in a matter of weeks. Learn more about SMARTS™ Rules Authoring capabilities.

  • Low-Code, No-Code:

    SMARTS™ not only provides the tools to automate claims decision logic and workflows but also provides the tools to create visualizations and user interfaces to make it easier for non-technical adjudicators and business users to manage claims decision logic and workflows. Learn more about SMARTS™ Low-Code, No-Code capabilities.

  • AI & ModelOps:

    SMARTS™ enables adjudicators and business users to leverage both explicit rules and AI in claims decision logic. Import and customize predictive models, trigger machine learning tasks, test different strategies, and much more. Learn more about SMARTS™ AI & ModelOps capabilities.

  • Decision Analytics:

    SMARTS™ enables business users to monitor, measure, and continuously improve claims decisioning outcomes through customizable dashboards, simulations, and alerts. Learn more about SMARTS™ Decision Analytics capabilities.

  • Lifecycle Management:

    SMARTS™ enables business users to manage claims decisions throughout their entire lifecycle transparently and securely with SMARTS™. Learn more about SMARTS™ Lifecycle Management capabilities.

SMARTS™ modern architecture fits any ecosystem and provides everything you need to achieve high performance, security, and scalability. Learn more about SMARTS™ Technical Architecture.

Improve Business Outcomes with SMARTS™