The Challenge

Identifying disability claims that meet approval requirements is a time-consuming and error prone process. An analysis by the Social Security Administration showed that some claims were taking over two years to be processed, much too long for very ill or elderly claimants.  The goal was to automatically evaluate disability claims to determine which could be decided within a 21-day time frame.

The Solution

In order to speed the claims approval process, Elder Research built an automated “express lane” to move the high-risk applications through the process more quickly. The text mining software automatically scanned incoming applications to approve high-risk applicants without forcing them to wait for the vast number of applications submitted before them to be processed.

Results

Our combined approach exceeded the accuracy of previous automated approaches and was equivalent to the accuracy of the combined judgment of the review committee. This allowed 20% of the claims to be approved immediately, focusing resources on the most challenging cases.

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