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Robotic Process Automation – Futureproofing The Health Insurance Industry

Robotic process automation as applied to the health insurance industry involves the use of automated software applications which restructure processes and reduce the amount of human labor-intensive works like claims processing.

Robotic Process Automation – Futureproofing The Health Insurance Industry


When it comes to the medical insurance industry, there’s one thing in abundance – paperwork. There are claims to be filed, data to be entered and cross-checked, documents to be strictly formatted … the list goes on and on. When you think about it, it’s really no surprise that the industry has a bad rep for being slow, ineffective, and pretty much the opposite of customer-friendly. After all, if your entire staff is engaged in dreary, time-intensive, clerical tasks, there is virtually no one left to do the critical and intellect-driven work.


Needless to say, the industry needs to be revamped, and their savior in this time of crisis is only one – Robotic Process Automation (RPA). RPA is basically the quickest learner out there. It uses a graphical user interface (GUI) to learn how to perform a task by watching its human counterpart. And what makes it so much more efficient (as compared to other similar tools) is that it can handle data across varied applications. For instance, it can take data from a bookkeeping system and use it to draft an email or vice versa.

This makes RPA a competent way of processing information that saves vast amounts of time and money. And if you’re not convinced already, it also has these five benefits.


Slow and Steady Won’t Win this Race

As is with any industry, the medical insurance industry regularly sees new players waltz in and out of it. They bring with them the enthusiasm of the unseasoned, the gusto of the bright-eyed, and most importantly, the technology of the young and enterprising. They process more, spend less, and make more profits than companies who’re still functioning on old processes.

So, how are these generation-old firms supposed to survive this influx of technology-driven insurance companies? Well, beat them at their own game, obviously!

With RPA, they’ll be able to match their contemporaries in speed and efficiency; all while being backed by a well-known name and established a reputation in the market. And the best thing about RPA is that, unlike with ERP or BPM, the transition is absolutely painless. It doesn’t need to be integrated with your outdated system and it supports all applications such as desktops, the web, legacy, as well as other remote devices.

Turn Around Your Turnaround Time

If there are two words that appeal to millennials, they’re ‘quick’ and ‘transparent’. Unfortunately, traditional claim processing is anything but that, simply because the data has to be pulled from multiple sources! This long, tedious, and often fruitless process is draining and makes one lose faith in the system. But RPA really does change the game. It aides insurers through the processing seamlessly, starting from the input of the First Notice of Loss (FNOL). After this essential first step in the claims process, it auto alerts loss adjusters as well as hands out assignments to claim handlers. So, it really is like the efficient assistant out there!

To Err is Human, to Perfect Robotic

Human beings make mistakes. You can like it, you can dislike it, but it’s a fact of life. They tire, get distracted, need breaks, and make ‘silly mistakes’. Natural as this tendency might be, in the world of insurance filing, this margin of error borders on the impermissible. At the same time, you can’t blame the data handlers as every single bit of the information has to be tiresomely typed into the system. Realistically speaking, with layers upon layers of administrative, managerial, and customer service functions, not to mention complicated forms and documents that are waiting to trip you up, even the most single-minded of people would crumble. But with robotic process automation, you can minimize, nay eliminate, user error completely.

Customer Maketh Brand

Ask any company that’s managed to stay in business long, and they’ll attribute their success to happy customers. Happy customers are loyal customers who stick with you even when they are offered more attractive deals because they trust you to carry out their operations with dedication and commitment. But when your workforce is too busy carrying out backend operations, customer service tends to take a backseat. This can be detrimental in the long term.

Luckily with RPA, you can free up your staff from tasks like data entry and divert their focus to more critical functions that actually add value to your customer’s lives. Besides, with RPA handling the processing, you decrease Average Handling Time (AHT) and increase First Call Resolution (FCR). This combination helps you resolve client problems proficiently, minimize follow-ups, and keep your customers as happy as possible.

Rules Are(n’t) Meant to Be Broken …

Especially when failing to comply with them can get you in huge trouble! Health insurance is subject to hundreds of government compliances such as HIPAA (Health Insurance Portability and Accountability Act), PCI standards, privacy rules, tax laws … and the list goes on and on. Each claim filed has to comply with the laws of the country they’re recorded in, which can get really complicated, especially for companies that operate in multiple regions. So, how do you make sure that a claim filed in Mexico abides by Mexican regulations and not Canadian?

RPA is the answer! With it, you can rest easy knowing that you never slip up by failing to comply with any rules. It ensures that each and every claim filed by you is in line with the compliance regulations put down by the country’s government and does it effortlessly. Look at the RPA software capable of sifting through thousands of laws in a second. Now, look at the unfortunate employee tasked with spending hours upon hours going through the same regulations. RPA is looking pretty good, right? That’s because it is meant for labor and time-intensive tasks like these that stop your employees from performing activities driven by thought and intelligence! So, make the smart choice here because it can make or break your success.

There you have it – five reasons why RPA is invaluable to the health insurance industry. It truly is the savior that claim filing needs to evolve into a more customer friendly, efficient, and accurate organism! So, what are you waiting for? Go into the age of technology with your head held high and claim filed right!

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