Insurance Claim Router Sent $47K Claim to Senior Adjuster in 3 Seconds (6 Nodes) 🔥

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$47,000 medical claim arrived. System routed to Senior Adjuster before the email finished downloading. Pre-authorization flag included.

Built claim processor. Amount-based routing. Automatic reimbursement calculation. No more claims going to wrong people.

THE CLAIMS ROUTING NIGHTMARE:

Every claim email requires manual review. Someone opens it. Reads amounts. Decides routing. Calculates reimbursement estimate. Checks pre-auth requirements.

Three different people. Three chances for error. Wrong routing delays payments.

THE DISCOVERY:

Document extraction pulls claim details. Code calculates reimbursement. Routing logic assigns based on amount thresholds.

Single extraction does everything. Routing happens instantly.

THE WORKFLOW:

Gmail trigger catches claim attachments → Get message downloads PDF → Document extraction pulls policy, claimant, incident, procedures with amounts → Code calculates reimbursement and determines routing tier → Sheets logs to claim tracker → Slack notifies correct adjuster with full details.

6 nodes. Claims routed automatically.

THE ROUTING LOGIC:

Amount thresholds determine assignment:

- Under $1,000: Auto-approve queue

- $1,000-$5,000: Claims Adjuster

- Over $5,000: Senior Adjuster

Pre-auth flags trigger automatically for claims over $500 without authorization numbers.

THE REIMBURSEMENT CALCULATION:

Code calculates: Total claimed - Deductible - Copay = Estimated reimbursement.

Adjuster sees the math before opening the document.

THE TRANSFORMATION:

Before: 22 minutes per claim for initial review. Pre-auth sometimes missed. Senior adjusters reviewing small claims.