AI4SMB_ppt_AI-Healthcare-Insuretech_2402 _short.pdf

AI4SMB-ppt in AI & Healthcare & Insuretech v2402 _short

1. © AI4SMB, 2308_08 by B´IMPRESS; vertraulich / confidential 1
AI4SMB
AI & Software
With Smart Essence
For SMBusiness Units
(Small & Medium-sizes Business Units)
Agena:
1
st
Presentation AI4SMB in Healthcare for
Insurances (#Insurtec)
2
nd
Presentation AI4SMB in General
(Overview w/ References)

2. PROBLEM AI SOLUTION
Overtreatment level in
clinics worldwide
Insurance companies
able to thoroughly
check only part of bills
received
?
9%
Low level of process
automation
PLUG-IN-PLAY
AI-SOFTWARE FOR HEALTH
ANOMALIES DETECTION
2

3. HEALTHANOMALIES DETECTION
HIGH LEVEL PROCESS
Invoice
receiving
Negotiation
with clinic
Input to
insurance
database
1100+ RULES/
ALGORITHMS
2-4
SAVINGS ON HEALTH
CLAIMS ACHIEVED
%
PRODUCT
Identify concrete suspicious services.
Based on International clinical guidelines,
standards and protocols(ICD-10)
TrainedMachine learning model
identifies complex patterns of fraud.
MACHINE LEARNING

4. TRACTION
из
Top-15
Achieved 2021
Medical
Insurance
Market share85
%
Insurance companies12
2018 2019 2020 F2021 F2022
$200.К
$700.КSales development
Already using the solution
$430.К
$520.К
$280.К

5. COMPETITION
Plug’n’Play
1day
Medical experts
3p. opinion
Pricing model
Success fee
for PoC -rd