Improving Insurance Claims Processing with RPA

  • by:
  • Source: Nuummite
  • 10/27/2020

Insurance companies are strictly regulated and must adhere to laws laid out by various local and global regulatory bodies. Ensure higher compliance with these regulations by letting the bot document every step of claims processing. This will significantly improve insurance compliance and governance as companies can monitor and audit the records on an ongoing basis without worrying about errors or missing data.

With the help of RPA, the claims processes can be streamlined, optimized, and accelerate with the multiple processes including entering data into the system from various channels such as emails, phone or online forms, verifying coverage, and issuing settlement notices. A claims adjuster bot like an IQ Bot can eliminate tedious manual processes of validating claims against the policy and review for fraud.

Insurance companies face multiple challenges. Customers’ expectations in terms of turnaround time, and omni-channel access continue to increase. Further, operationally intensive activities such as claims processing continue to erode profitability. Claims processing involves several managerial, administrative and customer service functions that perform information-intensive manual tasks to protect the company against fraud or errors. Despite all of this, in the US alone, the insurance industry is estimated to lose $80 billion every year due to fraud (The Coalition Against Insurance Fraud). No wonder claims processing with RPA is emerging as the new trend in the insurance industry.

With the company’s standards of service and its commitment to customers at stake, the scope for errors is next to none and the price of accurate claims processing cannot be underestimated. That is why more and more companies are turning towards Robotic Process Automation (RPA) as a solution to combat these problems. Some of the challenges to effective and error-free claim processing include:

  • Manual data entry: Traditional claims processing is heavily reliant on manual data entry, making the process inconsistent and full of errors.
  • Disparate mediums: The disparate medium through which information is processed and collected (like images, emails, papers) creates a lack of accountability and ownership.
  • Legacy systems: Lack of integration of legacy systems with newer solutions hamper productivity.
  • Data retrieval: Data retrieval poses a huge challenge when multiple software, processes, systems, and applications are used.
  • Regulation and compliance: Change in laws and regulation can severely impact the claims processing, posing a serious challenge for companies to remain compliant when operating in different states and countries.

IntelliBuddies® - Aids the healthcare enterprise to quickly process and settle the insurance claims operations. Before RPA came into existence, the process consumed many days of human efforts that involved multiple departments, authorizations involving workflows for approval, and other internal processes to complete. It comes with large set of very useful of activity libraries with built-in intelligent automation framework along with AI and ML capabilities to process the insurance claims processing automation very effectively and efficiently.

The Buddies can be trained to operate on all your existing applications. They can read, write, see, extract and load data, receive and respond to events, learn, think and provide data for your analytics. 

Buddies can perform the following automation tasks seamlessly using cognitive technologies in their respective processes: 

  • Performing repetitive tasks with Robotics
  • Learning with Machine Learning
  • Thinking with Artificial Intelligence
  • Listening with Speech Recognition
  • Responding with Natural Language Processing (NLP)
  • Reading from Optical Character Reader (OCR)
Source: Nuummite
INsurance Image by N/A is licensed under Unsplash Unsplash

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