Aetna says its new AI system is a direct response to provider feedback and will reduce processing time by over 20% for complex claims.
Hartford-based health insurer Aetna has launched a new AI-powered system that it says streamlines claims processing and improves payment accuracy.
It describes the Aetna Claims Assist Manager as an AI-powered agentic claims advisor platform.
Aetna says that claims processing is a major cost driver across the U.S. healthcare system, with administrative activities accounting for almost a quarter of total spending.
Aetna says its new AI platform is a direct response to provider feedback and will reduce processing time by over 20% for complex claims that require manual review.
Data from the 2023 CAQH Index, an industry source for tracking adoption of electronic transactions, showed that $89 billion (approximately 22%), is spent conducting administrative transactions.
The most recent 2025 CAQH Index found that more than $20 billion in cost savings could be achieved with more adoption of automatic and electronic workflows.
CAQH cautions that the savings should be considered within the context of the Change Healthcare ransomware attack, which occurred in February of 2024 and affected approximately 193 million individuals across the US.
The organization says the industry needs to focus on strengthening cybersecurity among other important measures.
