Parashift/Insurance/Health & Accident Claims Settlement
Insurance · Use-Case

Health and accident insurance claims settlement.

Medical and accident invoices reach health and accident insurers as Physician invoices, SwissDRG case bills, UVG accident notifications, or MTF XML files. Parashift extracts diagnosis, tariff position, treatment date, and invoice amount in structured form, automatically matches them against the applicable tariffs, and hands them off validated to your core system.

VAG · FINMA outsourcing-compliant DORA · EU AI Act Art. 6(3) C5 · SOC 2 · ISO 27001
Medical invoice · outpatientTariff checked
Insured personFankhauser, Nadine
Diagnosis (ICD-10)S82.2 · Tibial shaft fracture
Tariff position17.0210
Invoice amountCHF 1,240.50
Tariff checked, diagnosis validated, ready for payout
Pax CSS Orion
The process today

A dozen tariff systems, one review process per invoice.

Medical and accident invoices reach health and accident insurers in completely different formats: Invoices from independent physicians, SwissDRG case-based bills from hospitals, UVG invoices billed against the SUVA tariff, plus pharmacy, physiotherapy, and therapy invoices, and electronic MTF XML files from data exchange platforms. Every invoice has to be checked against diagnosis, tariff position, and treatment plausibility before payout — today largely through manual entry into the core system, which becomes a bottleneck for the claims team at high invoice volumes and delays queries back to providers.

Document list

What Parashift recognizes in every settlement.

Regardless of the tariff system, the benefit-relevant fields are captured in structured form and made available for tariff review.

Medical invoice (outpatient)

Diagnosis (ICD-10)Tariff positionTreatment dateInvoice amount

SwissDRG hospital invoice (inpatient)

Case numberDRG codeLength of stayInvoice amount

UVG accident notification & invoice

Accident dateSUVA tariff positionPolicy numberInvoice amount

Pharmacy & medication invoice

Pharma codeQuantityUnit pricePrescription reference

Physiotherapy & therapy invoice

Number of sessionsTariff codePrescriptionInvoice amount

MTF XML invoice (data exchange)

Invoice IDProvider GLNTariff systemAmount

Additional documents such as chiropractic or occupational therapy invoices are recognized just as reliably and routed to the matching tariff system.

Workflow

From intake to payout.

01 · INTAKE

Paper, scan, portal, MTF XML

Medical and accident invoices arrive through every channel at once and are ingested centrally.

02 · EXTRACTION

Diagnosis, tariff position, amount

Document AI captures every benefit-relevant field in structured form, regardless of tariff system.

03 · TARIFF CHECK

Tariff schedule, SwissDRG, SUVA tariff

Automatic matching against the tariff schedule and diagnosis plausibility before release.

04 · PROCESSING

Core system & payout

Cleared claims flow in structured form into the core system and out to the provider's payout.

Target systems

Integrates with your claims and core system.

Low-code connection through documented REST APIs, with no need to replace your existing infrastructure.

AdcubumGuidewireSAPmsg.GlobalInsiders SolutionSumex tariff reviewIn house systems

Compliance:

VAG outsourcing requirements (FINMA) DORA, in force since Jan 17, 2025 EU AI Act Art. 6(3) (procedural support task) C5 · SOC 2 · ISO 27001
Impact

What changes for your claims department.

90%

of medical and accident invoices captured automatically, SwissDRG and SUVA tariff included

3 Days

to a live pilot in your claims department

Success story

How AXA uses Parashift to settle medical claims.

AXA Health automates the processing of medical claims documents.

AXA Health uses Parashift's IDP platform to automatically process different types of medical claims documents, reducing processing time and operational costs.

With Parashift's IDP platform, AXA Health has successfully integrated a solution that enables a large number of documents to be processed automatically and the data to be validated.

One use case among many for insurance.

Property & liability claims processing, cost coverage approvals, and underwriting documents follow the same principle: read, review, hand off to the core system.

All use cases for insurance →

Process claims settlements automatically and audit-ready.

Book a no obligation 30 minute briefing: we will show you the processing of medical and accident invoices on real example documents.

Reply the same business day · no sales pressure