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Claims Processing

Definition

The end-to-end process of receiving, evaluating, and resolving insurance claims, including verification, adjudication, and payment.

Overview

Claims processing encompasses all activities from initial claim submission to final resolution. The process typically includes claim intake, initial review, investigation, adjudication (decision), and payment. Claims processing automation can significantly reduce cycle times and costs while improving accuracy. Key automation opportunities include document capture, triage, validation, and straight-through processing of routine claims.

Why It Matters

Claims processing is the single largest operating expense for insurers, and slow claims directly damage customer satisfaction and retention. Every day of delay increases costs and the likelihood of litigation, while manual errors in adjudication create compliance and financial risk.

How New Odyssey Helps

New Odyssey automates the end-to-end claims lifecycle with AI-powered triage, document extraction, and adjudication—enabling straight-through processing of routine claims while routing complex cases to the right adjuster.

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