A leading US-based health insurance company processed 40k claims over a period of 5 months. Let’s take a look at the details.
Before that automation:
– manual claims verification
– reduced efficiency and speed with higher risks
– lower capacity to support a large number of claims accurately
Process Flow Steps:
– extract claims from database
– search claims in health rules application
– validate and update claims status
– validate claim information as necessary
– generate claims report and send to business
After the automation:
– risk-based testing framework for validation and verification of claims
– over 300 claims per hour
– automated report generation for verified claims
So, the company got able to process a higher volume of claims while maintaining accuracy.
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