Caregiver invoices submitted for reimbursement include a wide range of services, care codes, and supporting documentation. These invoices are often unstructured — arriving via email, portals, or fax — and contain complex details that must be verified against contract terms, approved care plans, and payer policies.

Operations and compliance teams faced several persistent challenges:

• Manual validation of billed charges against care authorizations, rate schedules, and reimbursable service codes.
• Difficulty identifying non-compliant or duplicate charges, resulting in delayed payments and increased audit risk.
• High labor costs and slow turnaround times for invoice adjudication.
• Inconsistent documentation from caregivers, increasing the risk of fraudulent or erroneous claims.

The result: longer reimbursement cycles, increased operational risk, and inconsistent service provider experience.