Home|Nintex Blog|If billion-dollar savings isn’t enough, here are 5 more ways RPA is reviving the healthcare insurance industry

If billion-dollar savings isn’t enough, here are 5 more ways RPA is reviving the healthcare insurance industry

To say that the healthcare industry is drowning in a sea of paperwork is an understatement, particularly when it comes to healthcare insurance. From billings to submissions to actual claims, it appears the entire structure is built upon documentation.  With more than 3 billion healthcare claims filed each year, it comes as no surprise that improvement efforts are a top priority for healthcare insurance providers.

The sheer volume of paperwork to be accounted and documented in health claims processing makes it a prime candidate for automation. According to America’s Health Insurance Plans (AHIP), a national trade association representing the health insurance industry, approximately 80 percent of healthcare claims are now processed automatically.

The cost savings with RPA are significant: a claim requiring human intervention costs approximately $4 to process, while  Alsbridge, a global sourcing, benchmarking and transformation advisory firm, recently announced that the cost-per-claim with RPA systems can be as little as $1.25. According to their calculations, by applying RPA to extend auto-adjudication rates by an additional 10 to 12 percent, health care providers can generate savings well in excess of 1 billion dollars.

And if saving a billion dollars isn’t enough, here are 5 more reasons leading healthcare insurance providers are turning to RPA to revive and streamline their operations:

1. Beat the competition

Oftentimes, established health insurance companies find themselves struggling to compete with new competitors that have more modernized distribution and operational models, while much of their data is locked in antiquated legacy systems. Unlike previous automation solutions, RPA technology requires no integration with existing systems and it can support all applications effortlessly, including: desktop, web, legacy or remote applications.  As a result, RPA implementations can be up and running in days – providing a greater competitive advantage and a fast-track approach to ROI and revenue growth.

Also read: Your Next Automation Project Can Be As Easy As 1-2-3

2. Improve turn-around time

Today’s insurance customer expects quick, efficient service and enhanced visibility. The faster you are processing application claims and the more transparent that is; the happier your customer will be and the more likely that they will stay with you.  With Leo RPA, software robots are immediately called into action using an API as soon as a customer enters a claim.  By incorporating image recognition and optical character recognition (OCR) algorithms, software robots are able to “see” the screen and interact with an application just as a person would – but faster and with amazing accuracy. It can also be ramped up or down quickly in order to manage peaks in demand.  In some cases, turn-around times for claims queries have been reduced by 85%.

3. Eliminate user error

The health claims environment involves layers of administrative, managerial and customer service functions, marked by information intensive manual tasks and problematic document formats. It depends heavily on dozens, or even hundreds of people, manually keying in information, leading to unacceptable accuracy levels. Many of these tasks can be easily, effectively, and efficiently undertaken with RPA. Once deployed, software robots can work 24/7 with amazing accuracy, thus eliminating the margin of human error, increasing processing efficiency and cutting operational costs.

Also read: Is Your Claims Processing Helping You Save Money and Retain Customers?

4. Improve customer service

Relieved of the burdensome, repetitive tasks, employees are freed up to focus on providing real value to your customers.  With this in mind, the Leo 2-in1 platform was designed to support both virtual and human workforces alike, offering both full RPA as well as end-user performance support. Performance support helps your human workforce navigate business applications and accomplish any task, quickly and error free, by using in-application guidance and desktop automation. Companies using performance support technologies typically see lower Average Handling Time (AHT), increased First Call Resolution (FCR), and an overall improved customer experience.

Also read: How to Provide Excellent Customer Service in Insurance Contact Centers

5. Facilitate compliance

Health care insurance companies are subject to constant changes in government regulations and policy administration.  This problem intensifies many times over if the company operates in different states and countries, each with its own sets of laws and regulations.  Using RPA, you ensure that the process is executed in adherence to policy and regulations.

Watch our short video to learn more about how robotic process automation can benefit your health care insurance organization:


Kryon Systems is committed to assisting organizations realize their key performance indicators (KPI) by providing performance improvement solutions which support both the end-user and IT automation efforts alike.  To this end, we offer a comprehensive solution to the business user in the form of Leo Performance Support as well as a cost-effective answer to efficient process execution with Leo Robotic Process Automation (RPA).

Topics: Robotic Process AutomationRPA, insurance



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