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ADRES Enters Medical Claims Auditing Through Artificial Intelligence, Built with Blend
PR Newswire
Tue, August 18, 2026 at 11:18 PM GMT+5:30
4 min read
PAACME (Automatic Processing and Analysis of Medical Claims) uses cutting-edge technology to transform the processing and auditing of claims related to care provided to victims of traffic accidents involving uninsured, unidentified, or hit-and-run vehicles
BOGOTA, Colombia, Aug. 18, 2026 /PRNewswire/ — The Administrator of the Resources of Colombia’s General Social Security Health System (ADRES), in partnership with Blend360, a premier AI services provider, launched PAACME (Procesamiento y Análisis Automático de Cuentas Médicas). The solution automates the processing, analysis, and auditing of medical claims that clinics and hospitals submit for services provided to victims of traffic accidents involving uninsured, unidentified, or hit-and-run vehicles. Coverage also extends to claims arising from terrorist incidents and natural catastrophic events.
As an Anthropic Authorized Reseller for Amazon Bedrock, Blend deployed Claude on Amazon Bedrock, powered by Anthropic, including Claude Opus, Claude Sonnet, and Claude Haiku. These models were extensively used to interpret and structure complex medical documentation, transforming unstructured clinical records into standardized medical and administrative data. The models also enabled the evaluation of medical relevance and coverage across audited claims, the automation of key validations, and the integration of multiple data sources.
PAACME began operations in June and is expected to significantly reduce claims processing times, which can currently exceed four months due to adjustments and objections. ADRES aims to reduce this processing time to less than two weeks, helping improve cash flow for healthcare providers
Audit processing times were reduced by approximately 96%, decreasing from five hours per case to just 5 to 10 minutes. The cost per audit dropped by nearly 75%, while response times improved by up to 40 times, enabling ADRES to process a significantly larger volume of claims with greater operational efficiency
At the same time, PAACME strengthened data quality and decision-making capabilities. The use of Claude models improved reasoning over complex medical documentation, achieving 87% accuracy in medical components. The solution also reinforces transparency and oversight by ensuring traceability throughout each validation and safeguarding the proper use of public healthcare re
According to ADRES, in 2025 alone, the entity paid COP 702 billion in claims related to traffic accidents involving uninsured vehicles. During the same period, healthcare providers submitted 432,234 new claims, of which 99.6% corresponded to traffic accidents involving uninsured vehicles, representing more than COP 1.07 trillion
