Altertype* boosted member eligibility processing by more than 10x

Leveraging NLP and AI-powered RPA to dramatically improve member eligibility processing for a leading insurance broker.
Altertype
industry
Insurance
location
Miami, FL, USA
Challenge
Altertype faced significant challenges in processing member eligibility across multiple insurance carrier websites. The manual process was time-consuming and error-prone. With over 100,000 transactions processed annually, the company struggled to scale operations efficiently, risking customer satisfaction and market competitiveness.
Solution
We engineered a cutting-edge AI-driven solution using NLP, ML & RPA technologies in just under 8 weeks, delivering automated data extraction, intelligent plan matching, and scalable processing across multiple carrier websites with a human-in-the-loop system.

In an industry like insurance, where efficiency and accuracy are paramount, AI-driven solutions offer a transformative approach to streamlining complex processes and driving business growth.

Key Outcomes

  • More than 10x increase in eligibility processing capacity
  • 95% reduction in manual data entry
  • 85% improvement in processing accuracy
  • 70% decrease in processing time per enrollment

Strategic Impact

  1. Operational Efficiency: Automated processes significantly reduced manual workload for agents
  2. Scalability: AI-powered solution supports exponential growth without additional staffing
  3. Customer Satisfaction: Faster processing times and improved accuracy enhanced client experience
  4. Competitive Advantage: Positioned Finsense as a tech-forward leader in the market

AI-Driven Eligibility Processing: A Game-Changer

In today's fast-paced insurance landscape, manual processes can no longer keep up with demand. Our custom AI solution offered:

  • Intelligent Data Extraction: NLP algorithms accurately extract relevant information from internal systems
  • Smart Plan Matching: ML models intelligently match plans across different carriers, overcoming naming inconsistencies
  • Automated Processing: End-to-end automation of eligibility checks and enrollments, with a human-in-the-loop for review
  • Scalable Architecture: Cloud-based solution designed to handle growing transaction volumes

The Greenfield Labs Approach

Our AI development process ensured alignment with Finsense’s specific needs:

  1. Problem Analysis: In-depth interviews with team members to fully understand the challenges
  2. Requirements Documentation: Comprehensive outline of proposed solution, expected costs, and maintenance considerations
  3. Prototype Development: Built and tested a scalable prototype using 5 carrier sites
  4. Iterative Refinement: Continuous improvement based on real-world performance and feedback
  5. Full-Scale Implementation: Rolled out the solution across all carrier sites with focus on consistency and transparency
  6. Ongoing Optimization: Regular updates to NLP and ML models to maintain high accuracy and efficiency

“We engaged Greenfield Labs because it was clear that they deeply understood not just AI but also how to link it to real business value. We're now processing eligibility requests faster than ever, with remarkable accuracy. It's been a real joy to see the system come together and really help our agents do a better job.”

Ruth Blum, COO, Altertype

Conclusion

For insurance brokers facing the challenges of scale and efficiency, AI-driven solutions aren't just an option—they're a necessity for staying competitive.

Greenfield Labs delivers more than just technology; we provide a pathway to operational excellence and market leadership in the insurance industry.

*Company and Executive names changed for privacy

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