Abstract: Systems and methods are described herein for processing claims using rules engines based on specified conditions. A machine learning model may be trained using the outcomes of the claims processed using the rules engine. A trained machine learning system may be used in addition to or instead of the rules engine to process claims, estimate a liklihood of payment, and/or suggest modifications that will increase the likelihood of payment and/or the timeliness of payment.

Abstract: Systems and methods are described herein for processing claims using rules engines based on specified conditions. A machine learning model may be trained using the outcomes of the claims processed using the rules engine. A trained machine learning system may be used in addition to or instead of the rules engine to process claims, estimate a likelihood of payment, and/or suggest modifications that will increase the likelihood of payment and/or the timeliness of payment.