An RPA Solution for

Insurance Claims Auto-Download

About the Client

This is a health insurance agency with more than 30+ years of experience connecting individuals, families and businesses with well-known insurance brands. The organization provides services as independent agents that primarily help meet insurance needs for family, auto, property and business lines.

Problem


For close to 30 years, the agency utilized the same methodology that helped them achieve their long-term sustainability. As the company grew and technology advanced, they incorporated various upgrades that helped them work more efficiently to grow the business. Through all the process upgrades, the one that hadn’t changed was the manual claims download process.

To facilitate the claims process, the user must log into the portal and manually download the patient claims and all pertinent information individually, then go back and manually verify that all documentation had been accounted for. If there were any issues, the user would then have to go back and restart the process for all missing information. To compound the issue, missing information would prevent claims from processing correctly, which held up the entire payment of the insurance claim and resulted in an unhappy customer.

To meet revenue goals, the company realized that they needed a new and improved process, otherwise they would fall further behind the competition and begin losing clients. It was decided that Vee Technologies would be brought in to review current processes, identify upgrades and facilitate the necessary improvements.

Solution


After thorough analysis of the client’s processes and portal capabilities, Vee Technologies provided an RPA (Robotic Process Automation) solution to complete the necessary tasks. The bot would be deployed and pull all necessary information accordingly from the portal, while ensuring that all pertinent information was present in the file.

The bot would automate the process and work 24/7 to download the claims seamlessly, without any manual intervention. It would also provide error-free document verification for each individual claim to ensure that all necessary information was present and accounted for. Once the bot ensured that all claims were downloaded successfully for a particular group, it would trigger the process of moving the claims download folder to the prescribed client FTP location. Throughout the entire process, emails were automatically triggered every two hours to update the client on current progress.

This would solve the manual download and verification process, while ensuring accuracy, improving efficiency and increasing client satisfaction.

Result


The bot was deployed with no issues and instantly went to work. Production output increased significantly, and the quality of the work increased by around 95%. Any errors encountered were found to be caused by incorrect data within the portal and would need minimal attention to correct.

The bot processed around 10,000 records per day and reduced the FTEs required to do the job by 3, which were then shifted to other parts of the organization that needed additional resources. In the end, one FTE was tasked to monitor this process part-time while concentrating on additional process improvements. Client satisfaction increased and the client was able to bring on more business.

After 30+ years of success, the client was now positioned to scale and provide a competitive product for decades to come.

An RPA Solution for Insurance Claims Auto-Download

An RPA Solution for Insurance Claims Auto-Download

In these unprecedented times, Vee Technologies is committed to doing our part to help those in need. With the ongoing spread of COVID-19 (coronavirus) and the incredible speed at which things are changing around us, organizations are continually adapting their operations and business structure. Vee Technologies has the experience and capability to help your organization through this difficult time. We've expanded our continuity plan and infrastructure to accommodate the current business needs. Please do not hesitate to contact us when your need arises, our implementation team can have you up and running quickly and efficiently.

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