Published:
October 12, 2023
Category:
Healthcare / RPA
Client:
Healthcare Insurance Provider
TECHNOLOGY
Autosmic platform
RPA

Project Overview

In the intricate world of health insurance, where processing claims can feel like navigating a labyrinth, the introduction of Robotic Process Automation (RPA) emerges as the hero in our tale, slashing through inefficiencies and transforming the landscape. Picture it as the Iron Man suit for insurance processes, only without the flashy red and gold.

“The good physician treats the disease; the great physician treats the patient who has the disease.” – Sir William Osler, often regarded as the Father of Modern Medicine.

Challenges & Requirements

Our primary entity, an insurance company, confronted a formidable adversary in its claims processing department. The manual review process mirrored a slow-motion sequence, susceptible to errors, causing dissatisfaction among customers eagerly anticipating claim approvals.

Process

Cue the dramatic entrance of RPA, armed with the Autosmic framework and poised for action. This advanced software seamlessly integrated with the company’s existing systems, transforming routine tasks into a meticulously orchestrated automation dance.

  • Data Processing: RPA rapidly extracted information from incoming claims forms, cross-referencing it with predefined rules and regulations.
  • Database Management: Automatically, the software seamlessly navigated the company’s database, updating claim statuses with the finesse of a seasoned performer.
  • Customer Interaction: RPA transcended backstage operations, assuming center stage by communicating with customers, issuing notifications, and addressing queries with the charisma of a talk show host.
  • Exception Handling: For unexpected plot twists, RPA adeptly managed escalations and exceptions, directing them to the appropriate department for manual review.

The Journey

The implementation followed a phased approach, commencing with the automation of the most tedious tasks. Think of it as learning to ride a bike with training wheels before attempting a Tour de France. The company also established a governance structure to ensure RPA adhered to rules and met compliance requirements – a form of insurance for the insurance, so to speak.

 

Results

  • Efficiency Boost: RPA reduced claim processing time by an impressive 60%, outpacing the process faster than a Friday night pizza delivery.
  • Error Mitigation: Errors diminished by 50%, akin to vanishing acts, leaving behind a flawless claims processing performance.
  • Automation Surge: The daily processing of claims skyrocketed, transforming the company’s operations into an automation spectacle.
  • Cost-Efficiency: Operational costs plummeted, and customer satisfaction soared, creating a mutually beneficial scenario.
  • Workforce Optimization: The necessity for a legion of claim processors dwindled, enabling the company to reallocate resources akin to shuffling cards in a Las Vegas casino.

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