Amplify Health wins double honours for health payor innovations at the SBR Technology Excellence Awards 2026

Its end-to-end health claims processing platform automates claims adjudication and systematic leakage capture at scale.

Amplify Health won the AI - Health Insurance and Enterprise Software - Health Insurance categories at the SBR Technology Excellence Awards 2026, for transforming medical claims processing with its AI-driven and fully integrated platform solution. 

The solution addresses longstanding operational challenges in health insurance, where claims adjudication often relies on manual workflows, fragmented systems, and undocumented judgement. For a leading health payor in APAC, processing a single claim previously took one to two hours, with assessors re-entering data and interpreting benefit rules across multiple systems.

Amplify Health introduces an end-to-end solution that combines artificial intelligence with structured clinical coding and system integration. It automates data extraction from various claim formats, applies clinical encoding across more than 50 schemas, and enables adjudication through a unified rules engine. Each component operates on a shared data foundation that enables consistent decision-making and reduces reliance on manual interpretation.

"Amplify Health’s DRG and coding solution stands out for how clearly it combines clinical rigour with practical usability. It has the potential to improve coding accuracy, strengthen reimbursement integrity, and support more confident decision-making across teams," stated Marita Vavoulioti, Bain & Company Partner – Digital, Data, Growth, on behalf of the judging panel. 

Key innovations include the use of multi-stage AI and GenAI-assisted techniques to rapidly structure and encode claims data and detect fraud patterns – whilst avoiding common issues such as hallucinations and black-box reasoning – through the following features: 

Confidence Assessment

To avoid hallucination, when the system encounters uncertain or complex cases, it routes them to human assessors rather than producing unreliable outputs. Decisions made by human assessors are then encoded into the platform using governed templates, allowing the system to apply similar logic automatically in future cases.

Transparent Explainability

The platform also strengthens fraud, waste, and abuse detection through line-item analysis. Instead of flagging claims without context, it provides clear explanations tied to clinical and contractual rules, enabling faster and more accurate reviews whilst maintaining audit trails.

Systemic Flexibility

The solution is also designed to address challenges inherent to system modernisation projects, by offering a complete system integration through a unified semantic layer, whilst flexibly adapting to each payor’s operational reality through incremental deployment. Selected claim categories (specific to each payor) flow through the new end-to-end solution, whilst legacy systems continue to process all other categories, allowing for progressive surfacing of institutional knowledge through live operation and refinement of configured rules before scaling.

Their implementation delivered measurable results within the first year. In deployed use cases, claims processing time was reduced from as long as one to two hours to around four seconds on average. Automated processing increased from 0% to 50% achieved in the initial deployments, with a clear path to reach 80% as more claim types are integrated and coverage expands. Claims leakage detection improved from 5% to 40%, supported by more consistent rule application and enhanced detection capabilities.

The platform solution also enables workforce transformation. Assessors shift from manual processing to reviewing complex cases and refining system logic, building capabilities in clinical reasoning and AI governance.

The Singapore Business Review Technology Excellence Awards is the most prestigious awards programme for technological innovations, recognising exceptional companies in Singapore that are riding the digital disruption wave and leading the technological revolution and digital journeys of their respective industries.

The Singapore Business Review Technology Excellence Awards is presented by Singapore Business Review Magazine. To view the full list of winners, click here. If you want to join the 2027 awards programme and be acclaimed for your company's outstanding contributions in pursuit of technological innovation, please contact Danica Avila at +(65) 3158 1386 ext 217 or [email protected].