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Dynamic Allocation of Bots and Other Features of RPA at Blue KC

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Blue Cross and Blue Shield of Kansas City (Blue KC) is an independent licensee of the Blue Cross Blue Shield Association and a not-for-profit health insurance provider serving more than one million members in 32 counties in greater Kansas City and northwest Missouri and Johnson and Wyandotte counties in Kansas.

According to Chris Draven, Manager of Automation for Blue KC, the company got started the journey of automation in the midst of a global pandemic, 2020. Their goal was twofold to find immediate value within the organization. They wanted to make sure that they were paying for themselves as an automation capability within the organization. And then also really look at easing the administrative burden, especially in the claims processing world.

The first focus was to develop a Center of Excellence that allowed the team to agree from the beginning on what success looked like, especially if you’re being pushed to deliver ROI but also deliver enough ROI that you’re paying for the staff and the consultants and the software costs. It became important that they agreed from the beginning to what success looks like. And so they had to come together with the business, with IT, with the automation team, and finance to talk about how do they build a CoE and a cost-benefit analysis function within their CoE that allows them to identify the best opportunities that will drive that value and get them there.

One of the really key developments that Blue KC had in their journey, especially in 2020, was working with COVID-related claims. The management was able to focus the team on identifying any claim within their system that was for a patient who had a COVID-related diagnosis and help them achieve the max benefit as Blue KC as an organization had decided to pay claims at a certain rate. And they were able to leverage automation to not only identify those claims but then go back, reprocess those claims or catch those claims as they came in, and then pay them at that rate. So it was a huge success for Blue KC internally, but the success externally was that their members didn’t see any sort of abrasion or have any sort of concern about their COVID claims being paid.

A huge win for Blue KC was when they upgraded and began using more dynamic scheduling of their bots, or dynamic allocation of bots. Would schedule a bot process to run at a specific time on a specific day. And then that bot process would run and it would end. And the team quickly found that that’s not a way to scale when you have a variable size of a process. So sometimes it may need to run 100 claims, sometimes it may need to run 1,000 claims. Blue KC was able to use dynamic allocation in using triggers to create environments within the orchestrator that allowed them to deploy bots to heavier units of work. So if there were hundreds of claims and the staff only needed three bots to do that within a period of time, the automation team was able to allocate those bots dynamically and leave the rest of those bots to go on more work in another area rather than just simply scheduling them and expecting them to clock-in clock-out and then they’re done. So bots are working the whole time. They’re constantly working.


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