Aetna reduces claims processing time by more than 20% with AI to improve care experience

HARTFORD, Conn., May 26, 2026 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), today announced the launch 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.

About Aetna
Aetna, a CVS Health business, serves an estimated 37 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care professionals, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).

About CVS Health
CVS Health is a leading health solutions company simplifying health care one person, one family and one community at a time. As of March 31, 2026, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics and a leading pharmacy benefits manager with approximately 88 million plan members. The Company also serves an estimated more than 37 million people through a broad range of health insurance products and related services. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.

Media contact
Phil Blando
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SOURCE CVS Health