Another example is a Fortune 500 global healthcare insurer2 that recently outsourced its claims data processing activities to the tune of 2 million claims a year. This means that paper-based claims and the more than 100,000 claims received by e-mail and fax are captured and automatically validated before being passed to the adjudication process. The validation is done in accordance with a fully auditable process. Digital copies are securely encrypted and uploaded to a cloud-based processing system, where metadata is automatically extracted from the document and validated against the insurer’s policy database excerpts.
Validating paper-based claims used to be an inefficient, time-consuming process which tied up valuable resources. Now the insurer’s claims adjudication teams can access fully validated claims within hours of receipt. These business process services have improved response times, reduced local administration and minimized physical document management costs, saving time and money. It also makes for happier customers.
The company is also now better positioned to take the next step towards re-engineering their claims processes, introducing technologies to migrate customers to a web-based system which will significantly accelerate claim payment turnaround times and further reduce operational costs.