Vitória and Vita’s surgical reports

Project Indicators

Surgical report generation time

↓ SLA

Rejections due to filling errors or inconsistencies

↓ Denials

Reports returned due to documentation issues

↓ Returns

The Challenge

Vita refers part of its patients for surgeries that require a detailed set of documents before any authorization. The surgical report is the central document in this process: it gathers clinical data, TUSS and ICD codes, laterality, OPME materials, and insurance information. Filling depended on surgical assistants who consulted doctors and manually verified each insurance company's rules. Errors generated claim denials, returns, and in the most critical cases, delays in the surgery date.

The Solution

StaryaAI developed Vitória, a digital surgical assistant activated on demand by the Surgical Group's assistants. The agent accesses the database of doctors, partner hospitals, rules of approved insurance companies, and Vita's internal protocols to fill the report in a structured and technical manner. It collects the surgery data — the professional's medical license number, date, insurance, laterality, and surgical group — and generates an editable document, ready for medical approval before submission.

Completed and planned integrations

• Vita knowledge base
• Doctors and Surgical Group database
• Partner hospitals network
• Insurance rules (Omint, Care Plus, AmilOne, Gama, Sulamerica, Bradesco)

• Clinic Web (planned)

• Tasy (planned)

Documentation context in the case study

Vita serves 70 to 80% of patients as private.

A surgical report with errors can delay insurance authorization by up to 21 business days — the minimum legal analysis period after scheduling. Vitória reduces this risk by standardizing the filling based on each insurer's specific rules.

The Results

The project was structured to address three operational bottlenecks in Vita's Surgical Group: report generation time, return rate due to incorrect filling, and incidence of claim denials with insurance companies. Before Vitória, the flow depended on manual doctor consultations, internal templates, and individual verification of each insurer's rules.

With Vitória, the agent consolidates into a single automated flow information that previously required multiple sources. The assistant accesses the approved insurance database, the partner hospital network, and Vita's internal protocols in real time, generating a structured and editable report. Medical approval is maintained as a mandatory step before submission, preserving clinical responsibility.

The monitoring indicators defined by the client include volume of reports generated per period, average generation time, reprocessing rate, and non-validation rate by the surgeon. Post-implementation data will be incorporated into the case as soon as available.

Next steps

The next steps describe plans recorded in the case study; they do not confirm subsequent delivery.

1. 01

   Clinic Web Integration

   Automatic access to the patient's clinical history directly through the clinic's system.

2. 02

   Tasy Integration

   Automation of surgical file creation and data synchronization with the hospital system.

3. 03

   Profile expansion

   Expanding usage to other Surgical Group profiles beyond doctors and assistants.