Intelligent process automation

Eight big impacts for insurance claims processing

In a world where technology advancements are happening at lightning speed, many insurance organizations are still wrestling with outdated processes.  Challenges such as manual workflows, legacy systems, data security concerns, integration issues and increasing customer expectations for speed and transparency continue to affect claims processing across the board.

As technology continues its rapid advancement, the risks of not addressing and overcoming these challenges only increase over time: Inefficiencies expand, scalability is constrained, error rates increase, data accessibility and analysis are limited and operational costs grow.  Meanwhile, customer satisfaction and business performance suffer, directly impacting profitability. Customer experience is becoming a key differentiator in the insurance industry, with companies that prioritize speed and convenience seeing higher retention rates.

Conquering these challenges is key for efficiency, risk mitigation and future success. 

Adopting modern technology is necessary for insurance companies to remain competitive, mitigate risks and deliver the customer experiences demanded by today’s digital-first clients. This is where Intelligent Process Automation (IPA) comes into play.

The next-gen of next-gen

IPA combines and builds upon the power of artificial intelligence, machine learning and workflow automation to supercharge digital processes. It elevates these technologies by incorporating advanced decision-making, adaptive learning, and predictive analytics to optimize claims processing. IPA integrates seamlessly with existing systems and workflows, orchestrating end-to-end processes that break down silos and ensure data integrity across the organization. 

For insurance organizations, IPA offers the potential to modernize claims processing and accelerate innovation. Because of that, IPA is poised to come to the rescue for organizations — catalyzing claims processing modernization, advancing digital transformation initiatives and accelerating innovation across the enterprise.

Eight big impacts IPA can have on claims processing:

1. A turbocharge to efficiency: IPA takes automation to new heights, fueling rapid, high-efficiency claims handling, streamlining workflows, reducing manual efforts and expediting the settlement process. According to McKinsey, automation can reduce claims processing time by as much as 50%.
2. Significant cost savings: By minimizing errors, reducing the need for manual labor and optimizing resources, IPA can drastically reduce operating costs.  Studies show that automation can reduce the cost of a claims journey by up to 30%, delivering substantial savings across the insurance value chain. 
3. Accuracy and compliance: Precise execution of automated tasks, error-free form translation and seamless ongoing monitoring and maintenance of regulatory compliance all safeguard against risk and build ongoing reliability.  One example of this valuable functionality is the automated identification of appeals requests, which carry stringent industry-imposed penalties when not reviewed and dispositioned in a timely matter. Using intelligent document processing techniques to detect language and sentiment in healthcare documents that may indicate an appeal or expedited appeal, payers can increase member and provider satisfaction while avoiding significant penalty costs.
4. Data-driven decision-making: While RPA focuses on automating repetitive tasks, IPA incorporates AI and ML algorithms to analyze data, recognize patterns and make decisions. This means IPA can not only execute tasks but also make intelligent decisions based on contextual information, historical data and predefined rules. Leveraging advanced decision-making capabilities, IPA can handle more complex and dynamic processes, further improving efficiency and accuracy.
5. Elevated customer experience: Insurance clients increasingly expect faster, more transparent claims processing. By automating claims processing, insurers can reduce turnaround times from weeks to days or even minutes significantly improving customer satisfaction. In fact, automating claims processes can improve customer satisfaction by up to 20% by offering faster, more efficient resolutions, according to MoldStud.
6. Predictive analytics: IPA leverages predictive analytics capabilities to analyze historical data and patterns, forecast future outcomes or customer behaviors, identify trends and anticipate potential issues or opportunities. By, IPA can predict future events, such as customer behavior, market trends, or operational performance. This allows organizations to make proactive decisions, optimize resources, and mitigate risks, leading to improved business outcomes and competitiveness.
7. Adaptive learning: Unlike traditional automation solutions that follow predefined rules and instructions, IPA systems can learn and adapt to new scenarios and changes in the environment. ML algorithms enable IPA to analyze data, learn from experience, and continuously improve performance over time. This adaptive learning capability allows IPA to evolve and optimize processes autonomously, leading to greater efficiency and effectiveness in operations.
8. Cognitive automation: By incorporating natural language processing (NLP) and computer vision, IPA can handle unstructured data (like documents, emails or handwritten forms) and automate tasks requiring human-like reasoning. Cognitive automation has been particularly useful in auto and life insurance claims to process documents and images in real-time, improving accuracy and reducing errors.

IPA is set to unleash a new era for insurance claims processing. By embracing this revolutionary advancement, organizations can transcend the limitations of legacy systems and manual processes and usher in a future of high-efficiency, high-performance operations with consistently positive customer experiences.

Read more about intelligent technologies in our related eBook: Intelligent Document Processing: The cutting-edge technologies powering the future of business.

And learn more on our website about Conduent Automated Document Solutions.