Without Silia
- Review by manual sampling
- Tariff deviations slip through
- Overbilling caught too late
Provider Billing Alerting
Part of the Insurance
Reads each provider invoice line by line, cross-checks it against the agreement tariff and alerts with a zero to one hundred score on every deviation found.
Insurance
The context
Auditing every invoice by hand simply fails at scale
An insurer pays thousands of provider invoices a month. Checking each line against the tariff by hand is unfeasible, so the team samples or pays blind. Overbilling and tariff deviations slip through invoice after invoice and inflate the cost of claims with nobody noticing.
The solution
A control that reviews one hundred percent of lines
The agent reads each provider invoice line by line, cross-checks each item against the agreement tariff and gives it a zero to one hundred score. Lines within tariff flow on their own and the ones that deviate get flagged. The team reviews only the anomalies.
Key capabilities
A system that gets better with every question.
Line-by-line reading
Reads each provider invoice with OCR and splits item, quantity and price line by line, with nobody capturing or reviewing it by hand.
Tariff cross-check
Compares each item against the live agreement tariff and spots the off-tariff price, the duplicate and the item that does not match.
Deviation score
Gives each line a zero to one hundred score by how far it deviates from the tariff, to split a minor error from overbilling worth a review.
Prioritized alert
Sends the alert for the deviating invoices to the team, sorted by score, so they hit the highest amount first and release the rest.
With Silia
- One hundred percent of lines read
- Tariff cross-check on the spot
- Alerts sorted by amount
System
System integrations
During every call, Silia connects live to the systems your operation runs on — updating records, triggering workflows, and confirming actions without interrupting the conversation.
FAQs
Still have questions?
Resolution Desk
Ingests the claim file, builds the coverage table, coordinates providers with deadlines and escalates only the exceptions to the adjuster with context.
InsuranceProvider Network
Orchestrates each service with the network providers on their channel, logs the whole interaction and builds the reconciliation package when the service closes.
InsurancePolicy Document Onboarding
Onboards the policyholder over WhatsApp: receives their documents, reads them with OCR, validates RFC and ID against official sources and opens the file in the CBS.
InsuranceEndorsements & Renewals
Receives the endorsement request, extracts the change with vision, validates it against the product rules and runs it in the CBS with receipts and endorsed policy.
InsuranceClaim Notice
Receives the claim notice over WhatsApp, validates coverage against the CBS and opens the structured claim file in under two minutes, ready for the desk.
Insurance