Decision Infrastructure

Decision Infrastructure, offered by IntelliHuman, is a platform designed to bring consistent, explainable, and auditable decision-making to regulated workflows, with an initial focus on insurance claims, healthcare prior authorizations, and logistics exception handling. The tool addresses the challenge of encoding expert judgment into repeatable, transparent processes that meet regulatory standards, targeting environments where decision quality, auditability, and speed are critical.

The platform enables organizations to automate claims review, triage, coverage reasoning, and subrogation detection, providing audit-ready reasoning and policy citations for every decision. Specific features include claims triage that prioritizes complexity and routes cases to the appropriate adjuster, coverage reasoning that matches policy language to claim facts, and subrogation detection to identify third-party liability early. The system overlays on existing core management systems such as Guidewire and Duck Creek, integrating with organizations' current digital CMS environments via API access, rather than replacing them. Each decision is supported by a six-layer audit architecture, including policy citations, rationale, and the option for human override, ensuring transparency and traceability for regulators and auditors.

The tool is aimed at regulated teams and enterprises in industries such as insurance, healthcare, and logistics, particularly those handling high volumes of claims or prior authorizations. It is positioned for organizations seeking to improve decision speed and accuracy, with pilot design targets including 40% faster claim handling, 85% decision accuracy on coverage calls, 60% faster prior authorization cycles, and five times faster exception triage in logistics. Prospective users can participate as design partners in structured 90-day pilots, which include agreed KPIs, baseline capture, and before/after measurement, with no long-term contract required. The platform's outcomes are verified in production pilots using benchmarking against historical workflows and expert-reviewed datasets.

IntelliHuman offers preferred commercial terms to design partners who expand after a successful pilot. The company emphasizes that its approach is to overlay decision infrastructure on existing systems, focusing on encoding and verifying expert judgment rather than automating document intake alone. The platform is particularly suited for organizations with at least 500 claims per month in the target workflow and the willingness to share anonymized metrics for pilot evaluation.