Claims processes bogged down by errors, turnover, legacy systems
Rework costs $$ and forfeits renewals
Institutional knowledge leaks—gone forever
WorkDone Corporate Memory®, learns, retains and shares what your best people know.”
Joe Rogers
CEO, WorkDone.ai
We reduced rework by 53% in 90 days and kept our top adjuster’s playbook when they left the company.”
CEO
Midsize Insurance Carrier
WorkDone Results
decrease in remediation costs
reduction in claims cycle time
increase in policyholder retention rates post-automation
TRUSTED BY TOP COMPANIES
Public Sector Disability Insurer saved $1.1M annually with WorkDone.”
“AI agents captured 520+ process heuristics and reduced average claim resolution time from 16 days to 6.”
Joe Rogers
CEO, WorkDone.ai
How It Works
01.
Assess
Expertise Capture silently document how claims are handled
02.
Diagnose
Corporate Memory™ codifies repeatable best practices
03.
Optimize
Execute and optimize workflows with human-in- the- middle controls.
04.
Automate
Continuous improvement via feedback to operations management.
This is what AI transformation is supposed to look like.”
CEO
MidWestern Mutual
Proof of Value
Feature
AI Process Agents
Corporate Memory®
360° Observability
Agentic Claims Support
Compliance Automation (GDPR/PCI)
Benefit
Lower claim handling cost by 30–50%
Preserve expertise; eliminate handoff waste
Eliminate dark spots in process performance
Higher NPS, satisfaction in public channels
Audit-readiness. Less risk and fines.
Getting Started
Free 30-Min ROI Assessment Call — See How Much You Can Save.
Senior Executives at Healthcare Insurance Carriers & Payors About WorkDone Health
1. Strategic Alignment & Business Value
What measurable ROI can we expect? (Reduction in claim denials, administrative savings, impact on loss ratios, improvement in policy renewals etc.
How does WorkDone Health specifically address business outcomes for payors versus providers or health systems?
How quickly can we move from pilot to production? (What’s the timeline for realizing value?)
How does this fit into our existing digital transformation and compliance roadmap?
Will adopting this technology give us a market or regulatory advantage? (Are early adopters benefitting competitively?)
2. Regulatory Compliance & Risk
Is WorkDone Health compliant with HIPAA, SOC 2, HITRUST, and CMS requirements? (Are certification documents/audits available? How often is compliance reassessed?)
How does the platform accommodate evolving federal and state regulations (e.g., new CMS rulings, 21st Century Cures Act)?
Does the solution support granular audit trails and reporting to meet legal and regulatory obligations?
What mechanisms are in place for PHI de-identification during both training and production?
3. Data Security & Privacy
How is sensitive data secured in transit, at rest, and during process automation? (What encryption standards, access controls, and segmentation are used?)
Who owns the data processed by WorkDone Health? (Are there explicit data usage, retention, and destruction policies aligned with our enterprise standards?)
What is your incident response plan for data breaches or cyber threats?
Do you offer a Business Associate Agreement (BAA) and are vendors subject to independent security assessments?
How does WorkDone Health integrate with existing claims, EHR, and workflow systems (Epic, Cerner, custom legacy systems)?
Does the platform use HL7, FHIR, and other interoperability standards?
What resources are required on our side for initial setup and ongoing operation? (Low-code/no-code compatibility? IT involvement? Change management?)
Scalability: Can the solution support our volume (claims, providers, regions)? How does it perform in multi-entity environments or across subsidiaries?
What is the approach for continuous platform updates and integration with new payor-specific modules?
5. Clinical & Operational Impact
What impact will the platform have on first-pass claim adjudication, appeals, and fraud detection? (Concrete analytics, case studies, or benchmarks provided?)
How are best practices and process improvements codified, adapted, and rolled out enterprise-wide?
Does WorkDone Health offer pre-built automation for claims workflows and compliance reporting, or is customization always required?
What support exists for exception handling, manual overrides, and regulatory “edge cases”?
6. Vendor Due Diligence & Differentiation
What proven track record or clinical/economic validation does WorkDone Health offer for the payor market segment?
Who else is using the product in the payor space and at what scale? (References?)n (If reference customers cannot be named, what anonymized benchmark data is available?)
What are the unique differentiators of WorkDone Health versus established vendors or in-house solutions?
What does the vendor’s long-term roadmap look like, especially as new AI regulations and payer-specific use cases emerge?
Who underwrites the vendor’s liability for regulatory, operational, or security failures?
7. Change Management & Implementation
What is the recommended change management approach for rolling out this solution within a payer organization?
What does the onboarding and training process look like for staff at varying levels of technical expertise?
How are existing workflows, staff, and business processes impacted by implementation?
What kind of post-implementation support, SLAs, and escalation paths are available?
8. Ethics, Governance & Accountability
How are AI decision-making and automation processes governed? (Transparency, explainability, and oversight of automation — especially for adverse decisions)navex+2
What steps are taken to prevent and monitor algorithmic bias or unintended consequences?
How often are models re-audited to ensure fairness and compliance with evolving regulations?
9. Cost Structure & Commercial Model
What is the pricing model (subscription, per-claim, enterprise, user-based)? (Are there implementation or consulting fees?)
What is the total cost of ownership, including setup, integration, support, and ongoing upgrades?
How does pricing scale with growth — more claims, more users, more subsidiaries?
10. Future-Proofing & Vendor Stability
How is the vendor positioned with respect to recent market or regulatory shifts?
What is the company’s financial health, funding, and commitment to supporting large payor enterprise-scale clients?
Is there a clear roadmap for leveraging emerging AI models and adapting to regulatory changes?
Observations & Points of Uncertainty
Most payor executives seek concrete financial outcomes (fewer claim denials, administrative cost savings, improved audit rates) as well as explicit evidence of future compliance and risk mitigation.
Reputational risk and third-party validation (testimonials, published case studies, security reviews) are major gating items for adoption.
Vendors like WorkDone Health must demonstrate robust answers around integration, security, and ongoing vendor viability while providing clear differentiation versus more generic competitors or homegrown automation.