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Business automation heals healthcare insurance claims

Julianna Rice
July 18, 2022

Despite making its first appearance over a year ago, the ripples of COVID-19 are still felt wide and deep as the world struggles to deal with lockdowns, economic closures, and other fallout from the pandemic. Amidst all of the chaos, the healthcare industry has been turned upside down.

Due to the severity of the pandemic, many routine visits and procedures were postponed over the past year. But now that people are catching up on their scheduled healthcare, the burden on the health insurance industry is seen clearly. With initial industry analysis forecasting a large influx in claims processing channels, Cognitive Process Automation (CPA) fills a growing industry need.

Claims Automation is the Answer

When the country shut down, many non-emergency health procedures were put off, which could lead to more severe and complex claims. Now, insurance carriers are analyzing potential gaps in their claims processes.

The lifeline is simple really. The answer lies in an automation company that can perform business automation and process automation in order to get the healthcare claims back on track. One of the major keys to an optimized claims process is automated invoice processing, so that billing can be done quickly and efficiently.  

How to Improve Claims Processing  

With the flood of claims that are expected in 2021 due to many delayed elective and routine procedures from 2020’s pandemic lockdown, your company needs to be ready. When patients experience delayed claims due to processing problems, they may be tempted to change insurance carriers. If this happens too often, carrier retention rates could drop. Streamlining processes will lead to more customer satisfaction.

There are many parts of the insurance claims process that can be tedious. Software robots can improve the customer experience, and that’s where Digital Coworkers can be of the utmost assistance.

Digital Coworkers are self-learning and can read insurance documents, categorize the loss, and pass along the information without humans being involved. This frees up the humans to focus on the customer experience and customer satisfaction, rather than the mundane jobs that Bots can do. Roots Automation can set you up for success and take the worry out of claims processing.

Pamela Negosanti, Global Vice President of Insurance at expert.ai, said “These types of technologies can be used to guarantee reduced processing time. Customers want to receive an answer to their claim in two days rather than two weeks, and they’re happy to know insurers have an objective way to evaluate their claim [with the assistance of technology]. By using these tools, insurers can improve the customer experience, and therefore, improve customer retention.”

With over 20 checkpoints involved in a typical claims process, streamlining processes and implementing automation systems will handle simple underwriting tasks and procedures while you and your team can handle complex technical damage reports and the final validation of reimbursements.  

Ease the Burden of Your Overworked Staff

If the number of healthcare claims rise in 2021, your overworked staff will be more susceptible to human errors that could cause costly problems. Mundane work like insurance claims forms also leads to employee burnout and a high turnover rate.  

In order to create a satisfying work environment, employees need to feel self-actualization and to feel like their work matters. Bots can take some of the busy work away, leaving the humans both more refreshed and more streamlined to personally take care of the customers.

When humans do general administrative work or data entry, this is expensive for payroll and not engaging for the workers. This in turn will cause disengagement and lower productivity. Business process management can take some of the burden away from the overworked underwriters at your company.

According to RedHat, “Automation is working with algorithms to better organize business processes so that humans can do what humans do best—deal with higher-level tasks. By letting automation speed up and streamline your routine processes, your organization will have more time and energy to spend responding to client needs, cultivating relationships, and working on the next big thing.”

See also: How Medical Claims Processing Transforms Patient Healthcare

Prevent Revenue Loss from Delays in Processing

Every time there is a delay in processing a claim, you are losing revenue that is vital to the future of your company. Using Artificial Intelligence (AI) and Machine Learning (ML) can increase the value and revenue. AI is a stalwart process that not only can process your medical claims, but can also help you market and determine what might happen next.  

There are two ways that AI can improve revenue. First, they can understand the signals of supply and demand, and identify trends even if they are barely visible to humans. Secondly, AI can improve the speed with which a company can analyze a large amount of data and improve the accuracy of forecasts. This means that a company can make educated decisions in real time.  

Forbes magazine reports that “BCG found that automating revenue management systems’ pricing rules with AI can increase revenues up to 5% in less than nine months.” Although some businesses seem reluctant

The effects of the pandemic have trickled down to the claims adjusters at health insurance companies who are experiencing a plethora of claims headed their way in 2021. Take the leap to automate business processes in order to improve the claims processing system and keep your customer satisfaction rate high.  

Transitioning to a cognitive automation solution help your overworked employees focus on what is really important, the customer experience, rather than the mundane spreadsheets that overwhelm them. Finally, increase the revenue in your company by speeding up the processing and leaving more room for the bottom line.

Case Study: Reducing Monotony in Insurance


If you're interested in learning more about Digital Coworkers, schedule a demo of our product. Our team is always happy to discuss automation!

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