India-based Star Health Insurance has reached an agreement with Medi Assist, an India-based third-party administrator (TPA), to adopt MAtrix, an AI-powered claims platform, in a bid to help identify and eliminate fraud and reduction in waste and abuse through AI tools.
The AI platform will aim to help Star to strengthen its ability to manage rising claim volumes while maintaining speed, consistency, and transparency in its operations.
As part of the process, Star Health Insurance is scaling up its digital capabilities to meet growing service expectations from hospitals, policyholders and regulators.
The use of the platform will introduce intelligent automation, reduce manual steps, and streamline workflows, while enabling stronger turnaround performance across the network.
Star Health said a key advantage of the platform is its rules and configuration-based engine, which ensures consistent and standardised claims adjudication, which will reduce subjectivity and improve process accuracy.
It said the platform also enables co-working and AI co-pilot support, which allows Star Health Insurance’s claims teams to make faster and more informed decisions.
Additionally, it strengthens the company’s ability to detect and prevent fraud through advanced AI and machine learning tools, helping reduce waste and protect the integrity of the claims process.
Anand Roy, managing director and CEO of Star Health and Allied Insurance, said: “This marks a major step forward in strengthening our in-house claim management capabilities.
“This partnership is a key milestone in our journey to build a more agile and technology-driven claims ecosystem
“Claims are at the heart of the insurance experience, and with Medi Assist’s platform, we are enhancing speed, accuracy, and consistency, while keeping a keen eye on fraud, waste and abuse.
“By reducing manual interventions and standardising processes, we aim to strengthen efficiency and reinforce trust with our policyholders.
“This along with other initiatives being undertaken at Star Health Insurance will ensure our focus remains on delivering transparent, reliable, and customer-first claims service that meets the evolving needs of the health insurance and healthcare landscape.”
Satish Gidugu, CEO of Medi Assist, said, “We are excited to collaborate on this transformative journey.
“This partnership is set to redefine industry standards in technology-driven insurance operations, ensuring an exceptional policyholder experience.”