ADRES Enters Medical Claims Auditing Through Artificial Intelligence, Built with Blend

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 resources.

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.

For the government entity, this system represents a major transformation in the claims process by providing greater capacity, quality, and efficiency in auditing. For healthcare providers, it is expected to deliver significant benefits, including fewer administrative objections through early verification of information quality and a reduction in claim rejections, thereby optimizing recognition and payment cycle times.

"The use of technology in service of people transforms fragmented processes into solutions that address real needs. The collaboration between ADRES, Blend, and AWS demonstrates this transformation: reactive auditing processes evolve into models where data, advanced analytics, and cloud technologies enable faster, more accurate, and traceable decision-making."

— Karla Wong, Education and Public Sector Leader, Amazon Web Services

"This platform represents a turning point in the management of medical claims within Colombia's healthcare sector. Behind it lies rigorous work in data engineering and cloud architecture that enabled us to design models capable of interpreting, classifying, and auditing medical claims with a level of precision that previously depended exclusively on human judgment."

— Andrés Barrantes, Senior Vice President for LATAM, Blend

Through this transformation, ADRES strengthened its ability to manage healthcare system resources more efficiently, accurately, and transparently, laying the foundation for a scalable, data-driven operation that directly contributes to the sustainability of and trust in Colombia's healthcare system.

About Blend360

Blend360 is a premier AI services provider, committed to co-creating meaningful impact for its clients through the power of data science, AI, technology, and people. With a mission to fuel bold visions, Blend tackles significant challenges by seamlessly aligning human expertise with artificial intelligence. The company is dedicated to unlocking value and fostering innovation for its clients by harnessing world-class people and data-driven strategy. We believe that the power of people and AI can have a meaningful impact on your world. For more information, visit www.blend360.com. 

SOURCE Blend360