Healthcare

Cutting claims turnaround from days to hours.
Cutting claims turnaround from days to hours.
Cutting claims turnaround from days to hours.

No sales deck first call. Just a straight conversation about what's manual today, and whether an agent should be doing it instead.

No sales deck first call. Just a straight conversation about what's manual today, and whether an agent should be doing it instead.

No sales deck first call. Just a straight conversation about what's manual today, and whether an agent should be doing it instead.

Client

Codesandbox

Industry

Finance

Service

AI Agents

Timeline

6 weeks to live

Team Involved

2 engineers, 1 client lead

The Challenge

Northfield Ledger's claims team was reviewing every incoming claim by hand checking policy terms, verifying documentation, and cross referencing prior claims before a decision could be made. The volume had grown faster than the team, and by the time a claim reached the front of the queue, it had often been sitting for three to five business days. The backlog wasn't just a speed problem.

Inconsistent decisions were creeping in as analysts worked under pressure, and the compliance team was flagging a rising number of cases that needed rework. Leadership needed a fix that wouldn't require hiring their way out of the problem.

The Solution

AETHER built an agent that sits at the front of the claims pipeline. It reads each incoming claim, checks it against policy terms and prior claim history, and either resolves straightforward cases outright or routes edge cases to a human reviewer with a summary of why it needs attention. The agent was deployed alongside Northfield's existing claims platform no data migration, no new system for analysts to learn. It plugs into the same queue analysts already worked from, just clearing the straightforward 70% before a human ever sees it.

The Outcome

Within the first month, average turnaround dropped from just under four days to under eight hours. Analysts stopped triaging low complexity claims entirely and now spend their time on the genuinely ambiguous cases the agent escalates the ones that actually need judgment.
 Compliance rework dropped alongside the speed gains, since the agent applies policy terms identically on every single claim, removing the inconsistency that came from analysts working at different paces under pressure.

“We stopped losing the important conversations in the noise. The team finally has a clear path from a member question to a useful answer.”

“We stopped losing the important conversations in the noise. The team finally has a clear path from a member question to a useful answer.”

Maya Chen

Community Operations Lead

Your questions answered.
Your questions answered.

Let's find the first workflow worth automating.

Let's find the first workflow worth automating.

Let's find the first workflow worth automating.

How long does a typical engagement take?

Your first visit begins with a warm welcome and a personal consultation. Your therapist will explain each stage, discuss your comfort and goals, and tailor the treatment to you. You can ask questions or request adjustments at any time.

Do we need our own AI or data team?

What happens if the agent gets something wrong?

How early should I arrive for my appointment?

(Newsletter)

Be the first to know what’s new.

Be the first to know what’s new.

Be the first to know what’s new.

Create a free website with Framer, the website builder loved by startups, designers and agencies.