Using AI/ML for Prescriptions Claims Analysis for Major Health Solutions Provider
A major health solutions provider needed a practical way to identify and test more than 10,000 new scenarios. Spearhead implemented AI/ML solutions to automate the testing process and ensure no scenario type is productionized without passing the testing requirements.
Challenges
- Client has no practical way to identify and test more than 10000 new scenarios
- Running through its claims primary production system on a day-to-day basis then comparing with regression releases daily
Solutions Offered
- The AI/ML solution generates all possible claims scenarios (over a hundred million possible combinations) from auto-discovery of claims data objects generated by various development teams.
- The solution also identifies a statistically random representative sample drawn from the discovered scenarios’ population for regression testing.
- The solution automates the testing process and ensures that no scenario type is productionized without passing the testing requirements.