Healthcare🏥
Prior Authorization Workflow
End-to-end PA process from clinical request to payer decision. Maps denial triggers, ADR handling, and AI acceleration opportunities.
14 steps13% denial rate4 days avg cycle
View workflow →Healthcare📋
Medicare Claims Processing
837 submission through MAC adjudication and 835 remittance. CCI edits, medical review, and denial management process.
8 steps$500B+ annual14 days payment
View workflow →Healthcare⚖️
Insurance Claims Appeal Workflow
Denial receipt through external independent review. Internal appeal, peer-to-peer, and IRO process with 59% success rate data.
8 steps59% appeal success$35B recoverable
View workflow →Healthcare👤
Hospital Patient Onboarding
Scheduling through clinical handoff. No-show reduction strategies, digital intake, and HCAHPS impact analysis.
8 steps23% no-show rate$200/no-show loss
View workflow →Government🏛️
Medicaid Eligibility Enrollment
Application through coverage effective date. Federal Hub verification, MAGI determination, and post-PHE unwinding workflows.
8 steps90M+ enrollees45 days max
View workflow →Government🍎
SNAP Benefits Enrollment
Application to EBT card issuance. Expedited processing, interview requirements, income calculation, and recertification workflows.
8 steps42M participants30 days deadline
View workflow →Government📦
Unemployment Insurance Claims
Initial filing through benefit payment. Identity verification, separation adjudication, weekly certification, and appeals process.
9 steps$30B annual21% error rate
View workflow →Government🎖️
VA Benefits Claims Workflow
Intent to file through rating decision. C&P examination process, PACT Act claims, and multi-level appeals system.
7 steps125 days avg1.7M claims/yr
View workflow →Government📑
Federal Contract Procurement
Requirements definition through contract award. FAR acquisition cycle, set-aside programs, and small business opportunities.
8 steps$750B annually168 days avg
View workflow →Government🎁
Government Grant Application
Opportunity identification through award and compliance setup. Grants.gov, SAM.gov, 2 CFR 200 compliance workflow.
9 steps$1T+ distributed20% success rate
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