Healthcare claims processing is increasingly complex, making it resource-intensive and error-prone while impacting financial stability. Payers can improve accuracy, reduce costs, and enhance turnaround times by leveraging AI, automation, and analytics.
Sutherland’s AI-enabled Claims Administration solutions streamline the entire lifecycle, from intake to adjudication and resolution, reducing rework and exceptions while improving efficiency, accuracy, and member experience.
30%
Productivity gains
99%
Financial accuracy
40%
Reduction in processing times
20%
Improvement in provider satisfaction
Our Solutions
Unlock scalable and compliant healthcare claims solutions – powered by Sutherland’s integrated global delivery model, across the full claims lifecycle. By embedding AI into live claims operations, we enable continuous improvement in accuracy, turnaround time, and cost efficiency.
Claims Intake & Triage
Digitize and route claims using AI to improve intake accuracy and accelerate throughput.
Claims Adjudication
Use AI-driven adjudication to improve accuracy and reduce manual intervention.
Claims Review & Redetermination
Improve first-pass resolution with AI that reduces rework and enhances decision accuracy.
Claims Adjustment
Improve adjustment accuracy with AI while minimizing rework and accelerating resolution.
Payment Integrity
Use AI to detect anomalies, prevent overpayments, and reduce financial leakage.
Claims Automation & Analytics
Use AI and analytics to reduce exceptions, improve accuracy, and streamline claims processing.
Digitize and route claims using AI to improve intake accuracy and accelerate throughput.
Use AI-driven adjudication to improve accuracy and reduce manual intervention.
Improve first-pass resolution with AI that reduces rework and enhances decision accuracy.
Improve adjustment accuracy with AI while minimizing rework and accelerating resolution.
Use AI to detect anomalies, prevent overpayments, and reduce financial leakage.
Use AI and analytics to reduce exceptions, improve accuracy, and streamline claims processing.
Platforms
Why Sutherland
Deep Domain Expertise
With 30+ years of experience and 4000+ payer domain operation experts, we are uniquely positioned to deliver measurable outcomes through our advanced healthcare payer solutions and healthcare payer services.
Cost Savings
Harnessing 15+ payer digital platforms, we can help healthcare payers streamline operations and reduce administrative overhead to reduce costs to enable competitive pricing and optimize resource allocation.
End-to-End Transformation Partner
A carefully selected set of enterprise and point solution partners across the payer value stream help deliver exceptionally engineered experiences.
Outcome-Based Engagement Model
More than 70% of our client engagements use outcome-based/TCO models, meaning we take full ownership across the entire lifecycle to deliver outcomes aligned to specific business goals.