Case Study | Healthcare

Enhancing Claims Intelligence with AI-Driven Analytics

Transforming claims processing into a scalable, near real-time system that delivers accurate insights and reduces operational delays.

Overview

A trusted leader in life sciences needed to modernize legacy, weeks-long claims processing across hundreds of millions of rows. 10Pearls delivered a cloud-native data platform on AWS with distributed processing and AI-driven entity resolution to accelerate analytics and improve accuracy.

Reduced processing time
from weeks to hours

Improved data accuracy
with AI entity mapping

Challenge

The client’s legacy on-prem systems were processing massive healthcare claims datasets in multi-week cycles. The process was resource-intensive, error-prone, and provided limited insight into practitioner and prescriber behaviors. Fragmented HCP identity data made it difficult to perform accurate analytics or target communications effectively. These inefficiencies hindered reporting accuracy, delayed client deliverables, and increased operational costs.

Solution

10Pearls rebuilt the client’s claims intelligence system into a distributed AWS platform capable of processing hundreds of millions of records in hours rather than weeks. Apache Spark on Amazon EMR enabled large-scale data processing and machine learning-driven entity resolution to unify fragmented practitioner records. Amazon S3 and Amazon Glacier provided secure storage and archiving, while Amazon Redshift powered high-performance analytics and Amazon QuickSight delivered interactive dashboards. Event-driven automation with AWS Lambda and Amazon ECS, monitored by Amazon CloudWatch, streamlined ingestion and orchestration. This modernization accelerated processing, improved accuracy in practitioner mapping, reduced operational overhead, and provided a scalable foundation for ongoing AI-driven analytics and reporting.

Related case studies

Improving Platform Reliability with Real-Time Monitoring

Healthcare


Improving Platform Reliability with Real-Time Monitoring

Real-time monitoring improved ServiceNow platform reliability with better device tracking, centralized support, and stronger operational visibility.

Modernizing Service Operations with ServiceNow CSM

Healthcare


Modernizing Service Operations with ServiceNow CSM

A customized ServiceNow CSM solution streamlined healthcare case management, improved agent productivity, and created a more scalable service model.

Accelerating Clinical Knowledge Delivery with AI

Artificial Intelligence


Accelerating Clinical Knowledge Delivery with AI

An AI-powered knowledge delivery solution helped clinical teams access the right information faster, improving speed, accuracy, and decision support.

Improving Speed & Security Across Health Systems

AWS


Improving Speed & Security Across Health Systems

Health system modernization improved speed, strengthened security, and created a more dependable digital experience across critical operations.

Accelerating Care Delivery with Intelligent Automation

Healthcare


Accelerating Care Delivery with Intelligent Automation

Disjointed healthcare workflows were unified with intelligent automation, improving patient journeys, communication, and operational efficiency.

Transforming Diabetes Care with Cloud AI

AWS


Transforming Diabetes Care with Cloud AI

Cloud AI transformed diabetes care with a scalable event-driven platform that cut infrastructure costs, reduced incidents, and improved response times.

Improving Patients Engagement With Conversational AI

Artificial Intelligence


Improving Patients Engagement With Conversational AI

10Pearls helped healthcare providers improve patient engagement with conversational AI that automated follow-ups, reduced clinician workload, and sped up care responses.

Medical Device Tracking

.Net


Medical Device Tracking

10Pearls modernized medical device tracking with real-time asset visibility, smarter inventory management, and faster field service decisions.

MSK Telemedicine Platform

Healthcare


MSK Telemedicine Platform

A personalized MSK telemedicine platform improved plan adherence by 55%, reduced surgical referrals by 89%, and transformed patient care.

Centralizing Electronic Health Records

Appian


Centralizing Electronic Health Records

A centralized EHR platform gave clinicians a single source of truth, reducing admin costs by 10% and improving care delivery.

Ready to get started?

Contact us today to learn how we can transform your products or ideas into scalable solutions that drive business value and growth.

Privacy Overview
10Pearls Logo

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly necessary cookies

Strictly necessary cookies should be enabled at all times so that we can save your preferences for cookie settings.

Third-party cookies

This website uses third party tools such as Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages.

Keeping this cookie enabled helps us to improve our website.