Adroitent RPA Solutions are designed to help Insurers in Health plans, P&C, Re-insurance to significantly reduce costs and increase their operational efficiencies, in complex claim adjudications, non-compliant underwriting, customer care, and a number of internal processes and sub-processes that need rectifications from routine nagging errors that would otherwise result in delays in processing and employ avoidable FTE overheads to cover manual processes. For instance, a particular insurance business required manually processing of the edit changes that took ten to fifteen minutes, whereas software robots could do the tasks in one to two minutes or less. The RPA solution completely removed the claims team from this edit work, replacing approximately ten to twelve FTEs with robots. It also provided the ability to handle sudden increases in claims volume with more robots, instead of reassigning claims agents to low-value work.
With Adroitent RPA Solutions, healthcare insurers can achieve more efficient way to process coordination of benefit claims. Even the most complicated adjudication rules can be automated easily. For example, the insured are covered by their health plans and their spouses’ plans. This means the insured’s COB provisions must be understood and their benefits coordinated between plans—in such a way that everything is covered and payment does not exceed the total claim. However, the claims agent must look up information in many documents to properly process this claim: at a minimum, the attached explanation of benefits (EOB); the summary of benefits (SOB); and the benefits grid. Plus, any other attachments to the claim file. Adroitent RPA solution will put these claims in a work queue for robots to assemble all the necessary documents, then place everything in the claims agent’s folder. Taking this assembly work away from the agents and allowing them to focus exclusively on adjudication decisions, will shift significant hours from low-level documentation tasks to high-value claims processing work—for each agent.
Adroitent’s RPA Solutions can help large property/casualty insurers - that operate different call centers handling thousands of monthly customer inquiries that range from direct sales to claims submissions and claims status - to achieve greater agent productivity, better customer service, and higher customer service levels. They would involve agents pulling/placing data from/into a complicated web of siloed databases, Citrix environments, and legacy systems even just to make a change of address. Adrotient RPA solution solves the cost and complexity of back office issues with unmatched, noninvasive Citrix, mainframe, and legacy automation technology. Each customer representative is empowered to trigger instantaneous data pulls or data sharing across systems with their own agent-assist workstation robot. What could be a complex and disconnected system of applications and databases can be gathered into a holistic, desktop view for every agent. This will result in customer service surveys with consistently higher rating levels.
Since growth and consolidation are a common occurrence among small and regional insurers, process, procedure and system differences arise because some offices were the result of organic growth and others from acquisitions. Policy renewal profitability becomes key a management concern. Poor process controls for the renewal workflows particularly around information collection and procedures would become bottlenecks. In such situations, Adroitent RPA solution can be deployed to tackle the most serious renewal workflow weakness: underwriting. By placing the renewal policies in an RPA underwriting work queue, robots pull valuations from Nada, KBB, Edmunds etc., and reach an average valuation by applying business rules and use that valuation with the rating engine as a basis for quoted premiums. The approach achieves valuation compliance; increased precision and reliability of valuation data; brings scalability to the workflow; adds six figures to profitability by producing accurate, competitive premiums.