Document Classification & Upload
Claims handling agents of a leading insurance provider monitor an email inbox for incoming documents from patients, doctors, laboratories, and other healthcare players containing different types of reports, receipts, claims, and more, in the form of PDF files. It is the agent's job to classify these documents and upload them into the right system for further processing or archival purposes.
- Review incoming PDF files and manually identify document type
- Navigate claim database to look up corresponding claimant data
- Reach out via email in case of incomplete or unreadable data
- Manually rename file as per naming guidelines
- Navigate AdminSuite to upload file, manually entering contextual data
- Manually rename incoming email and archive
- Use smart extraction with AI to capture relevant document data
- Automatically look up and validate claim data without switching systems
- Get automated email drafts when documents aren't readable
- Identify indexing labels with AI and get document title
- Upload documents to AdminSuite with inbuilt validation at the click of a button
- Automatically re-label and archive emails
The Matterway Assistant supports claims handling agents by automating the classification and filing of incoming documents into the policy database. By operating directly within the agent's existing workspace, it bridges the gap between document intake and core systems, ensuring that every file is accurately extracted, validated, and archived without requiring the agent to manually toggle between different applications.
The Assistant utilizes smart extraction technology to automatically capture relevant data points from incoming documents. This removes the need for manual data entry, as the AI identifies and pulls key information such as claim numbers, dates, and policyholder details directly from the digital files.
Once the data is extracted, the Assistant automatically looks up and validates the claim information against the internal database. This verification happens instantly within the current window, allowing the agent to confirm the document's validity without switching systems or performing manual searches.
The Assistant uses AI to identify the correct indexing labels and provides recommended titles for each document. This ensures consistent naming conventions across the policy database, making it easier for downstream teams to locate specific files during the claims lifecycle.
After the document has been classified and labeled, the Assistant handles the process of uploading it to the Admin System. It navigates the system's upload interface automatically, ensuring the document is placed in the correct category or folder with all associated metadata attached.
To maintain an organized communication history, the Assistant automatically re-labels incoming emails to match the newly classified documents. This preparation step ensures that the email thread is properly formatted and ready for formal archival alongside the claim file.6
When the Assistant encounters documents with missing or unclear data, it automatically drafts an email to the sender requesting the necessary information. The agent can review and adjust the draft before sending, ensuring professional communication while saving time on manual composition.
The Assistant is designed to recognize complex scenarios, such as when a single report contains data for multiple claims that needs to be split. In these instances, the Assistant recommends manual handling to the agent, ensuring that high-complexity tasks receive the necessary human oversight.
Built-in validation checks act as a safety net to prevent errors, such as attaching documents to the wrong policyholder account. The Assistant cross-references the document data with the active account on the screen, flagging any discrepancies before the upload is finalized.9
At the end of the day, the Assistant performs an automatic bulk archival of all re-labeled emails. This final step clears the agent's queue and ensures that all processed communications are formally stored in the appropriate system locations for long-term records management.
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