ADRES Launches AI Medical Claims Auditing System with Blend360

ADRES, Colombia's health system resources administrator, and Blend360 have launched PAACME, an AI system for medical claims processing and auditing, announced in a press release.

PAACME processes claims submitted by clinics and hospitals for care provided to victims of traffic accidents involving uninsured, unidentified, or hit and run vehicles. It also covers claims tied to terrorist incidents and natural catastrophic events.

Blend360 deployed Claude on Amazon Bedrock, including Claude Opus, Claude Sonnet, and Claude Haiku. The models interpret medical documents, convert clinical records into standardized medical and administrative data, evaluate medical relevance and coverage, automate validations, and connect multiple data sources.

PAACME began operations in June. ADRES said audit processing time fell by about 96%, from five hours per case to 5 to 10 minutes, while audit cost dropped by nearly 75%. The agency aims to reduce overall claims processing time from more than four months to less than two weeks.