Large Regional Third-Party Claims Administrator
Crosstie
How a Large Regional Third-Party Claims Administrator Turned Document-Heavy Demand Reviews into a Competitive Advantage
THe Context
Turning Document-Heavy Demand Reviews into a Competitive Advantage
A TPA cut demand review times by up to 75%, giving their adjusters back an average of 3.4 hours each week.
Closure rates improved, and one adjuster doubled their number of claims settled. Time-sensitive demands stopped requiring routine extensions. Adjusters caught pre-existing conditions they would previously have missed. Negotiating with attorneys became a different conversation. Patterns across attorneys, providers, and states are now visible.
It cuts the review time exponentially.
— Executive Vice President Large Regional Third-Party Claims Administrator
When a demand package landed in Annie’s inbox, her first reaction wasn’t to open it.
Twenty years in the business meant she knew exactly what was coming. The package might be 200 pages. It might be 500. It would almost certainly arrive as one long, unsorted document: the emergency room bill buried somewhere in the middle, the specialist’s notes out of sequence, the treatment records from six different providers in no particular order. Before she could evaluate a single thing, she’d have to spend 30 to 45 minutes just figuring out what she was looking at. And experience doesn’t make 500 pages any shorter.
The TPA she works at handles claims on behalf of insurance carriers nationwide, including complex, multi-provider injury cases with strict response deadlines and significant financial stakes. For their adjusters, demand package review was one of the heaviest lifts in an already demanding job, and the one most likely to create bottlenecks, missed details, and delayed resolutions.
“I used to dread getting demand packages,” Annie said.
“Everything would pile up. If you didn’t get through one, it was like a ripple effect.”
It’s a feeling the industry knows well. Something had to change. That’s where Crosstie’s Intelligent Document Processing (IDP) came in. IDP is a tool that automatically ingests, organizes, analyzes, and summarizes demand packages so adjusters can focus on evaluation rather than excavation.
75%
3.4
55%
25–60
The Challenge
A Process That Consumed Hours Before the Real Work Could Even Begin
No two packages looked the same. Every attorney organized them differently. Records arrived out of sequence. Fonts, formatting, and handwriting quality varied wildly. Adjusters handling claims across multiple states could never establish a rhythm because there was no pattern to learn.
The process punished thoroughness. Every page had to be read carefully to locate billing amounts, diagnoses, treatment dates, and prior conditions. A single review could take two to four hours, or a full day for larger files.
Critical details hid in plain sight. Pre-existing conditions, treatment gaps, inconsistent dates, and referral patterns were buried inside dense records. Even experienced adjusters acknowledged that under time pressure, things slip through.
Slowdowns cascaded downstream. Delayed reviews meant delayed carrier reports, delayed authority requests, and routine extension requests on time-sensitive demands. The inefficiency spread through the entire pipeline.
THe Solution
A Tool Built With Adjusters, Not Just for Them
The TPA partnered with Crosstie to implement IDP (Intelligent Document Processing) inside their existing claims platform. From the beginning, the build was shaped by direct input from the adjusters who would use it. They helped refine the output format, validate accuracy, and flag issues before rollout.
Automatic structure from any document. IDP ingests a demand package, regardless of format, size, or organization, and produces a structured summary. Medical records are sorted by provider. Treatment timelines are sequenced. Billing totals are broken down by what was billed, what was paid, and what remains outstanding.
Every finding linked back to its source. Each data point in the summary is cited and linked to the exact page in the original document, highlighted for immediate verification. Adjusters can confirm a finding in seconds rather than scanning hundreds of pages manually.
A consistency check that catches what humans miss under pressure. IDP’s cross-check feature automatically surfaces discrepancies across the full document set, including conflicting dates of loss, treatment gaps, and references to prior injuries or conditions. These flags give adjusters a concrete starting point for deeper investigation.
THe Results
Faster Closures, Stronger Negotiations, And A Measurable Return
So far, review times have dropped by up to 75%. This gives their adjusters back an average of 3.4 hours each week.
Based on survey responses, adjusters averaged over two hours per demand review before IDP. After implementation, review times dropped by an average of 55%, with some adjusters reporting reductions of up to 75% on the heaviest packages. Across the team, that adds up to roughly 3.4 hours back per adjuster per week. Time that is now spent on deeper investigations, stronger carrier reports, and higher-value claim work.
Average review time: Before IDP: 2–4 hours → After IDP: 25–60 minutes.
Closure rates improved, and one adjuster doubled their settlements. With faster reviews, adjusters moved through their pipelines more quickly. Several reported direct improvements to their closure ratios. One adjuster noted they had doubled the number of claims settled since the tool went live.
Time-sensitive demands stopped requiring routine extensions. Deadlines that once triggered extension requests are now met consistently because adjusters can begin their evaluation soon after a package arrives, improving both compliance and carrier relationships.
Adjusters caught pre-existing conditions they would previously have missed. The structured output and consistency check made it significantly easier to identify prior injuries and treatment history that predated the incident. These findings directly influenced claim valuations and gave adjusters stronger footing in negotiations.
Negotiating with attorneys became a different conversation. Having a cited, structured summary in hand during settlement discussions meant adjusters could reference specific records in real time, something opposing counsel often couldn’t match.
Patterns across attorneys, providers, and states are now visible. The team now has visibility across their entire demand history in a Crosstie data dashboard: attorney-level trends, provider patterns, and the overlap between law firms and medical providers. When loss trends spike in a particular state, leadership can then see what’s driving it.
THE CONCLUSION
The Pause Before Opening Them Is Gone
Annie still gets demand packages in her inbox. Some of them are still 500 pages long. But the pause before opening them is gone.
Now her process is straightforward: As soon as a package arrives, Crosstie’s IDP gets to work, so that by the time Annie dives in, the analysis is already done. The records are sorted, the timeline is sequenced, the billing totals are calculated, and inconsistencies are flagged. Everything she needs to evaluate the claim and make her case to the carrier is already organized and waiting.
The hours she used to spend sorting through records are now spent on deeper investigations, stronger carrier reports, and better-prepared negotiations.
I used to dread getting demand packages. Now I get excited to go into the system. It’s just so much better.
— Annie Senior Claims Examiner
Our company is very satisfied with the IDP product that assists adjusters in reviewing demands.
— Executive Vice President Large Regional Third-Party Claims Administrator
