HARTFORD – Aetna announced the roll out of the second generation Aetna Claims Assist Manager (CAM), an AI-powered agentic claims advisor platform designed to streamline claims processing and improve payment accuracy.
Insurance claims processing remains a major cost driver across the U.S. healthcare system, where administrative activities account for roughly a quarter of total spending. According to the 2023 CAQH Index, providers and health insurers spend an estimated $80 billion each year managing administrative transactions. The 2025 CAQH Index also estimates the healthcare industry could save more than $20 billion each year through further automation of administrative processes, including claims-related workflows.
CAM, with adjuster AI agents, reduces processing time by over 20% for complex claims that require manual review, helping providers get paid faster and more consistently. Bringing together eligibility, coverage, member and provider data, AI agents automate resolutions and recommend next-best actions.
"Claims Assist Manager shows how we are using AI to modernize the fundamentals of healthcare operations," said Katerina Guerraz, EVP and Chief Operating Officer at Aetna. "By reducing manual steps and accelerating decision making, we are delivering faster, more reliable outcomes for providers and members."
The platform responds directly to provider feedback. In Aetna's recent provider survey, reducing administrative burden and simplifying insurance processes ranked among the highest priorities.
Claims Assist Manager is part of CVS Health's $20 billion multi‑year investment in digital innovation aimed at simplifying the U.S. health system and creating a more seamless experience for consumers. Beyond claims processing, CAM demonstrates how automation, predictive analytics, and intelligent workflows can modernize complex administrative operations—at scale—while improving the provider and member experience.
