Insurance & Healthcare
Price every claim line before you pay
Adjusters spend their day retyping bills instead of deciding claims. DTE checks every line against the fee schedule and the policy first, so the desk only sees what actually needs judgment.
Today
What this costs you now.
01
Leakage is something the auditors find, not you.
02
You need more capacity. Nobody's handing you more adjusters.
03
The same procedure gets billed twice, caught after payout, if ever.
claims_processing_pipeline
01sources3://claims/intake/*.pdf
02structureclaim_no · member_id · cpt_code · charge
03joinpolicies on member_id
04joinfee_schedule on cpt_code
05checkcharge <= allowed_amount
06checkcount(*) by claim_no, cpt_code = 1
07destinationpostgres://claims.adjudicated
preview okruns on your schedule
With DTE
What you get instead.
Auto-pricedEvery line checked against fee schedule and policy
Desk sees exceptionsOnly lines needing judgment reach the adjuster
Duplicates caughtRepeat billing flagged before payout, not after
Leakage visibleSee where the money's going before the audit does
Other teams
Same engine, different paperwork.
Finance · Accounts PayableInvoice processing & 3-way matchingMatch every invoice before you approve itProcurementPurchase requisition & PO complianceProve the rate you negotiated heldHR & People OpsEmployee document & background-check reviewKnow who's compliant before the auditCompliance & RiskKYC document verificationWalk into the exam with evidence ready