“INSURING” Back-office automation success for a U.S. Health Insurance Company

THE WHOLE STORY

HGS has automated several key processes for this insurancecompany, including:

Member Enrollment Process
Previously, 90 percent of the member enrollment data had to be manually keyed into 12 different product lines toggled between 20 different screens in multiple applications. Each enrollment could take 15 minutes to complete, and quality was suffering—80 percent of errors occurred during the manual entry process.HGS implemented Automation Anywhere in a two-step solution: leveraging the built-in rules engine by converting the XML data into a complete electronic application and enabling seamless business validation and data entry from the electronic enrollment applications into the system.

Commercial Claims Testing Audit
This audit, which tests specific claims scenarios on more than 150 bundled claims, is highly tedious, repetitive, and, at five minutes to test just one claim, very time-consuming. HGS implemented Automation Anywhere in two phases: first, to automate the screen capture process, and second, to automate the claims testing process.

Healthcare Product Build
Building a health package under a given s insurance plan is highly time intensive, taking up to 22 hours for each package. HGS designed a three-phase solution utilizing Automation Anywhere. In the Build phase, Automation Anywhere Bots collect all required information from various spreadsheets. In the Validation phase, Bots match business rules, validate line items, and enter details in the client application. In the final phase, the Bots update the client application.

The Benefits and Improvements
Automating several of the most time-consuming, manually intensive, and error-prone processes has enabled HGS to deliver significant added value to this U.S. healthcare insurer’s back-office environment.