Process complex claims in hours, with zero compliance risk.
Claims arrive as messy emails, PDFs, and photos — not clean structured data. Rollio reads the unstructured reality, cross-references it with your policy systems, and empowers AI Agents to intake, validate, and adjudicate claims autonomously or prep them for a Human Supervisor. No data scientists required.
Rigid systems cannot read human context.
Standard claims systems and RPA bots demand perfectly structured data. But the reality of a claim—a dispute, a medical record, a damaged shipment—is inherently unstructured. When your system can't read the context, automation stops.
Highly skilled adjusters spend 50% of their day doing manual data entry: reading emails, extracting numbers, checking coverage limits in another system, and verifying compliance. This manual bottleneck results in 5–10 day processing times, compliance gaps at audit, and massive labor costs.
50%
Time on intake & validation
30%
Time on compliance & docs
5–10d
Processing time
10–15%
Findings at audit
Contextual intake, autonomous adjudication.
Rollio bridges the gap. By contextualizing unstructured intake channels with your core claims system, our AI Agents can execute the entire workflow—validating policies, enforcing compliance, and adjudicating standard claims end-to-end.
Contextual Intake & Extraction
Agents read emails, portals, and scanned paper, extracting and normalizing data to open cases cleanly in your system.
Autonomous Policy Validation
Instantly cross-references the extracted claim data against the member's specific policy, coverage limits, and exclusions.
Continuous Compliance
Enforces timely-notice rules, verifies required documentation, and maintains HIPAA/regulatory compliance automatically.
AI-Driven Adjudication
Applies policy rules to adjudicate clear-cut cases autonomously. Escalates complex edge cases to human adjusters with full context summaries.
Automated Payment & Rationale
Issues approved payments and automatically generates detailed, contextual rationale letters for the claimant.
Audit-Ready Transparency
Every AI decision and extraction is permanently logged. Auditors see exactly how a decision was reached, eliminating compliance risk.
The business impact: Processing time reduced to 1–2 days, compliance findings dropped to near zero, and cost-per-claim reduced by up to 60%.
How the Claims Agent operates in reality.
Claim intake
- 1Receive claim (email, portal, paper)
- 2Extract and normalize fields
- 3Verify member/policy
- 4Check coverage and exclusions
- 5Open case in claims system
- 6Acknowledge to claimant
Before
2–4 hrs
After
15 min
Compliance audit
- 1Pull case file and supporting docs
- 2Check timely-notice and deadlines
- 3Verify required documentation
- 4Run regulatory checks
- 5Generate audit-ready report
- 6Flag any gaps for review
Before
2–3 days
After
30 min
Adjudication & payment
- 1Apply policy and coverage rules
- 2Calculate eligible amount
- 3Route exceptions to a person
- 4Approve within limits
- 5Issue payment
- 6Notify claimant with rationale
Before
5–10 days
After
1–2 days
Measurable impact on speed, compliance, and cost.
Baselines and targets are set during your consultation, anchored to your current claims volume and lines of business.
| Metric | Today | With Rollio |
|---|---|---|
| Processing time | 5–10 days | 1–2 days |
| Compliance findings at audit | 10–15% | 0–2% |
| Rework rate | 5–8% | <0.5% |
| Cost per claim | $15–25 | $6–10 ($500K–$2M/yr) |
Your 90-day path to hands-free claims.
- Week 1–2
Discovery
Map intake channels, claims system, policy and compliance rules, and the email/document context around them. Identify the highest-impact opportunities and define a 30-day pilot.
- Week 3–6
Pilot
Rollio starts handling intake and compliance checks on a defined slice, within the rules and limits you set. Real-time measurement and team training begin.
- Month 2–3
Scaling
Expand to adjudication, payment, and appeals. Performance tuning, more lines of business, and broader team enablement.
- Month 4+
Full Speed
Claims in hours, not days. 100% compliance posture, consistent decisions, and your team focused on complex cases and customer experience.
Common questions.
Ready to deploy autonomous Claims Agents?
Let's map your intake channels and identify the highest-volume claims ready for autonomous adjudication.