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CASE STUDY

AI Document Intelligence for Claims — Healthcare (KSA)

A Saudi healthcare group and insurance administrator was struggling to keep up with paper based claims, scanned PDFs, and medical reports coming from hospitals across the Kingdom.

How We Turned Unstructured Claims Into Structured, Auditable Data

Before the project, each claim bundle could include scanned handwritten forms, discharge summaries, invoices, lab reports, and prior approvals, all in different formats and quality levels.

Claims officers had to open each file, find the right fields, type them into multiple screens, and decide whether to pay, pend, or reject. This slowed reimbursements and made it hard to enforce benefit rules consistently.

AlgoCAS worked with operations, IT, and compliance teams to design a document intelligence layer on AWS that sits in front of the existing claims system.

Incoming claims are captured from email, SFTP, and portals into S3, processed by AI based services for OCR and extraction, and enriched with validation rules.

The result is structured, trustable claim data that feeds existing workflows without forcing a core system replacement.

Document Types : Medical claim forms, invoices, EOBs, prescriptions, pre authorization letters, discharge summaries

Volume : Tens of thousands of pages per month, with peaks during seasonal campaigns and regulatory cut offs

Primary Stakeholders : Claims operations, provider relations, finance and audit, IT and cybersecurity teams

Scope

  • Order processing,
  • Returns triage
  • Customer follow-ups
  • Inventory alerts

Goal

  • Reduce manual workload
  • Speed fulfillment
  • Improve CX while keeping MENA compliance

70%

Faster
Data Capture

50%

Fewer
Manual Corrections

24+

Claims
Auto Classified

The Challenge

Automate claims intake without breaking existing systems or compromising compliance.

Teams were processing claim bundles one by one, often working overtime near month end and policy deadlines.

Handwritten forms, low quality scans, and mixed Arabic English content led to frequent rekeying, missing fields, and disputes with providers and members.

The client needed better visibility into who touched each claim, how decisions were made, and whether benefit limits and policies were applied consistently.

Our approach — simple, measurable, MENA-ready

AlgoCAS designed a focused, low-risk delivery plan

Assess

Map existing order flows, exceptions, and integration points (ERP, WMS, payment gateway).

Iterate

Tune triggers, fallback rules, and multi-language templates for Arabic/English dialects.

Pilot

Deploy Amrny on a subset — e.g., late-hour order confirmations and refund triage — to measure impact.

Built for scale

Roll out to full order lifecycle with observability and FinOps controls.

Revolutionize Your Workflow with Amrny

Amrny transforms your business by automating tasks 24/7 with cutting-edge AI. Say goodbye to delays and hello to efficiency, tailored for MENA’s unique needs. Start experiencing instant task execution today.

Trust Amrny for Unmatched Reliability

With Amrny, expect consistent, secure performance every time. Built on AWS and Informatica, it ensures compliance while cutting costs—perfect for MENA enterprises seeking dependable automation.

Our Approach – Simple, Measurable, MENA Ready

AlgoCAS designed a focused, low-risk delivery plan

L

Assess

We started with discovery sessions with claims, provider relations, and IT teams to map the end to end journey of a claim bundle. We sampled real documents from multiple hospitals and pharmacies, catalogued document types and layouts, and identified the core fields needed by the claims engine and finance. We also captured regulatory constraints for data residency, encryption, and access control in KSA.
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Design & Build

Using those findings, we designed an AI document pipeline on AWS. Documents land securely in S3, are processed by Amazon Textract and LLM based mappers to extract and normalize key fields, and then classified by claim type and provider. Validation rules check policy numbers, coverage limits, and mandatory fields before data is pushed into the existing claims and ECM systems via APIs. Exceptions and low confidence cases are surfaced on review queues instead of silently passing through.
L

Prove & Handover

We ran side by side pilots on historical claims, comparing AI extracted data with human keyed records to tune models and thresholds. Once accuracy targets were met, we switched new traffic into the pipeline for a subset of providers, then gradually extended coverage. We trained internal IT and operations teams to monitor extraction quality, update templates, and onboard new document types without depending on external consultants for every change.

Empower Your Team with Amrny’s AI Power

Amrny equips your team with smart tools to work smarter, not harder. From setup to success, our support unlocks new potential, driving growth across KSA, UAE, and Egypt.

It ensures compliance while cutting costs—perfect for MENA enterprises seeking dependable automation.

Implementation Milestones

A three week path from first workshop to production pilot for priority providers.

Week 1

Discovery workshops with claims and IT, sample collection, document cataloguing, and definition of required fields, validation rules, workflows, and data mapping.

Week 2

Build the ingestion and extraction pipeline on AWS, configure models and validation logic, and integrate with staging instances of the claims and ECM systems.

Week 3

Run pilot on live claims from selected providers, monitor accuracy and SLAs, refine thresholds, and train internal teams before expanding to additional providers.

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CASE STUDIES

Real Results, Real Impact

Discover how we’ve transformed MENA businesses with AWS (and Informatica where applicable).

SAMA Compliant Cloud Foundation — Banking & Government (KSA)

Delivered a secure multi-account AWS landing zone aligned to SAMA and NCA with encryption, centralized logging, and least-privilege IAM.

Group Analytics Lakehouse — Real Estate & Property Dev. (UAE)

Built a governed data lakehouse with automated pipelines from ERP, CRM and external sources.

AI Document Intelligence for Claims — Healthcare (KSA)

Automated classification and data extraction from PDFs and scans with human-in-the-loop review.