About

The largest pharmacy chain in the United States by number of locations and part of an American Fortune 10 group partnered with Sakha in streamlining claims processing. The chain was struggling with the increasing amount of data generated by its claims processing system. With a large volume of claims coming in every day, the pharmacy chain’s existing data pipeline was struggling to keep up with the demand. The system required manual intervention, and it was not scalable to handle the growing volume of data.

The Challenge

The pharmacy chain was facing the following challenges with its existing claims processing data pipeline:

• The existing data pipeline was slow and unable to handle the growing volume of claims data.
• The process required manual intervention, which was time-consuming and error-prone.
• The pharmacy chain lacked the ability to perform advanced analytics on the claims data due to the limitations of the existing data pipeline.

Solution

The pharmacy chain partnered with Sakha’s team of experts in ML and Big Data to design and implement a claims processing data pipeline orchestration system. The new system automated the entire claims processing workflow, from data ingestion to data cleaning, transformation, and loading. The system also included an AI-powered claims validation module, which automatically detected errors and anomalies in the claims data, reducing the need for manual intervention. The key features of the new system include:

• Automated claims processing workflow.
• ML-powered claims validation module.
• Scalable and flexible data pipeline architecture.

The new claims processing data pipeline orchestration system provided the following benefits to the pharmacy chain:

• Improved efficiency and accuracy of claims processing, resulting in faster turnaround times for customers.
• Increased scalability and flexibility of the data pipeline, enabling the pharmacy chain to handle larger volumes of claims data.
• Reduced manual intervention in the claims processing workflow, resulting in fewer errors and reduced labour costs.
• Enhanced analytics capabilities, enabling the pharmacy chain to gain insights from the claims data and improve its business operations.

Developed by Sakha, the new claims processing data pipeline orchestration system helped the pharmacy chain to streamline its claims processing workflow, reduce errors, and gain valuable insights from its data.