Muoro Built an AI System to Cut Denials by 60%
A healthcare tech firm partnered with Muoro to build an AI-driven denial management system, cutting resolution time by 60% while reducing manual effort and improving claim visibility.Business Goals
Mission
Automate denial management in healthcare by turning raw EDI 835 files into structured insights, reducing manual work and speeding up resolution with AI.
Challenge
Manual claim processing was error-prone and slow. Hospitals lacked tools to track denials, extract insights, or manage uploads securely at scale.
Need
The client needed intelligent automation, secure hosting, AI-assisted analysis, and real-time dashboards, all delivered in a scalable, production-ready platform.
About Client
Our client is a healthcare technology company focused on streamlining claims processing for hospitals and medical institutions.
The platform was designed to:
- Allow hospitals to upload EDI 835 files for automated parsing
- Analyze denial trends using AI for faster resolution
- Store and track denial records in a centralized database
- Provide secure web-based access with institutional-level authentication
The client had deep healthcare domain knowledge but lacked backend capacity to build this from the ground up.
The Challenge
Despite a strong product vision, the client faced key development roadblocks:
EDI Parsing Complexity
Raw EDI 835 files were difficult to process, requiring custom logic to extract usable data.
No Central Dashboard
Hospitals couldn’t track denial history or monitor uploaded files in one unified place.
Security & Access Gaps
Admins lacked role-based access, custom domains, and secure production deployment.
Missing Production Monitoring
There was no file-level visibility after upload, undermining accountability and trust.
The Muoro Solution
Muoro provided a backend engineering team to deliver secure infrastructure, intelligent parsing, and AI-powered analytics, fast.
Faster Denial Resolution
The platform now parses EDI files automatically and uses AI to suggest next steps, helping hospitals resolve claims 60% faster.
Real-Time Admin Access
Admins gained full visibility into uploads, denial trends, and resolution history without needing developer support.
Scalable, Secure Infrastructure
The platform runs on AWS with secure domain access, role-based permissions, and monitoring tools for long-term scalability.
All Technologies Used
Final Outcome
Muoro built a domain-hosted, AI-enabled denial management platform that processes complex healthcare files in real time. The client now supports multiple institutions with a secure, scalable system that reduces manual work and improves resolution speed.
Need to Automate Data-Heavy Healthcare Processes?
If you're working with large datasets like EDI or claims records and need intelligent backend automation, Muoro delivers engineers with healthcare expertise to build real-time, secure systems.
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