Blue Cross Blue Shield of Massachusetts uses an AI system, built in partnership with technology company iQuartic, that automatically ingests and scans millions of claims data points to identify billing gaps, miscoded procedures, and misdirected care. This system operates as an internal tool within the company's claims processing workflow.

According to the company's chief architect Lee Green, Blue Cross uses what he described as 'soft artificial intelligence' to process claims meeting certain data criteria. Working with iQuartic, a natural language processing developer, the system automates the ingestion of claims data and scans for errors including miscodings and instances where care was directed to inappropriate settings. Identified errors are flagged for correction to reduce costs for members, providers, and the insurer.