QA Complete - File Review

Real-Time File Review

Real-Time File Review

Agentech’s AI-powered file review solution built to support carriers, TPAs, third-party providers, and IA firms in auditing claims with greater speed, precision, and consistency. Our team of digital coworkers automatically reviews claim files submitted by field adjusters, desk adjusters, and third-party service providers.

Hundreds of specialized agentic agents ensure that every file includes proper documentation, adheres to estimate logic, contains accurate photos, sketches, and more. They also verify compliance with carrier and reinsurer guidelines, as well as alignment with local, state, and national regulations. By automating these essential but repetitive tasks, QA Complete enables human reviewers to focus on high-impact decisions, delivering both operational efficiency and improved claim outcomes.

For teams relying on offshore QA operations, QA Complete offers a faster, more consistent, and more secure alternative that scales instantly and reduces audit backlog.
Real-Time File Review Report Example

Real-Time File Review Report Example

Why It Matters

Manual review is time consuming, inconsistent, and resource intensive. QA Complete™ eliminates the bottlenecks by applying advanced AI agents trained on real-world claims data, jurisdictional rules, and carrier-specific expectations. The result is faster cycle times, fewer errors, and a measurable improvement in file quality and compliance oversight.

Infinitely scale without adding labor.

How It Works

1

Secure File Ingestion

Closed claim files are exported into a secure cloud environment and automatically processed by QA Complete’s AI agents

2

Structured Review by Tier

  • Phase I: Verifies basic documentation and compliance
  • Phase II: Validates estimates, depreciation, and scope alignment
  • Phase III: Supports assisted manual review with AI-generated guidance
3

Rules Engine and Checklist Validation

QA agents use a configurable “digital brain” to apply carrier-specific policies, municipal codes, and audit protocols.

4

Automated Annotations and QA Summaries

Generates audit-ready reports highlighting compliance gaps or confirming alignment.

Who it Helps

Desk Adjusters

Receive cleaner feedback and better support

Claims Supervisors

Speed up QA cycles while improving consistency

QA Teams

Focus on complex reviews while AI handles routine checks

Executives

Gain visibility into audit trends and performance metrics

Organizations it Helps

Insurance Carriers

Support in-house desk teams and automatically audit IA files

IA Firms

Boost file review productivity and accuracy; improve SLAs

TPAs

Prove file integrity to carrier partners with confidence

Third-Party Repair and Restoration Companies

Ensure accuracy of scope and estimate against carrier and policy guidelines 

Results You Can Expect

Up to 70 percent reduction in manual QA hours
Fewer claim reopenings due to missed documentation
Full audit trail for every reviewed file
Faster audit cycles with batch review capability
Stronger compliance alignment with carrier guidelines

TPA Use Case Spotlight

Third-Party Administrators using QA Complete™ can validate every claim before sending it back to the carrier. Whether integrated into your existing claims system or used as a standalone tool, the platform supports flexible deployment and scale. With full traceability, customizable logic, and secure operation, TPAs can mitigate risk and enhance operational trust.

See QA Complete™ in Action

Give your QA team the digital boost it needs. Let AI handle the repetitive work so your experts can focus where it matters most.

Discover how QA Complete™ can transform your claims audit process.
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