Robotic Process Automation – A holistic approach to operations in Healthcare Insurance

by Rajesh Agarwal, on Dec 27, 2018 4:29:56 PM

Estimated reading time: 3 mins

Technology disruption waves sway the markets from time to time. An enterprise needs to define a strong vision accompanied by a detailed blue-print of the Robotic Process Automation (RPA) implementation.

Robotic Process Automation – A holistic approach to operations in Healthcare Insurance

RPA has gained significant momentum, and is imparting strong impetus to businesses. It has a ‘T-shaped’ depth spanning horizontally and vertically. Not only does it emulate repetitive and transactional administrative tasks, which are rule-based but is also applicable across all industry sectors.

Insurance sector has undergone a vast transformation due to this technology. RPA has had a major impact on the back-office operations, such as Customer Onboarding, Policy Issuance, Customer Servicing, Claims, Revenue Cycle Management, etc. However, the technology needs to be properly implemented to ensure a scalable, responsive, and automated workforce that is quintessential in the digital market.

A highly diversified Fortune 500 company in healthcare improved their policy eligibility verification process with RPA.

Robotic Process Automation – A holistic approach to operations in Healthcare Insurance

The automated workforce or the RPA units called iBots have played a strong role in handling the frequent crests and troughs in the workflow of the Insurance sector. The RPA proofs-of-concept by themselves help reduce 40-80% of processing time while providing value-adds in terms of quality outputs. At the same time, the logs that are generated are helpful for auditing and risk management on an on-going basis. Organizations are already re-investing the financial efficiencies reaped through RPA in scaling their businesses.

However, not all processes can be slotted for RPA. In order to experience a good success rate of RPA implementation, the enterprise needs to adopt a holistic approach. From a strategic perspective, they need to conduct a proper due diligence of the tasks that can be identified for RPA. The tasks that are repetitive, rules-based, and manually intensive and the tasks, which classify as low complexity and high volume, are ideal for RPA implementation.

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thumbnail RPA-1-1

Today, organizations are deploying Advanced Robotics, which uses Artificial Intelligence/Machine Learning. With this, even tasks with high complexity and high volume are becoming good candidates for RPA along with a helping hand from Document Processing or Electronic Data Capture technologies, popularly known as Optical Character Recognition, and process realignment.

Top 38 pre-processing must-haves for Intelligent Data Capture.

Top 38 pre-processing must haves for Intelligent Data Capture-1

Now, tasks such as Pre-Adjudication, Policy Administration, and Claim Management in Healthcare Insurance sector are immensely benefiting due to RPA. Technology advancement is also allowing bundling of RPA implementation with Payer Analytics, Provider Analytics, and Dashboards so that Payers experience benefits across the value chain.

Artificial Intelligence transforms the Robotic Process Automation landscape to make it more productive.

How AI transforms the Robotic Process Automation landscape to make it more productive-1

Advantages of RPA in Healthcare Insurance

Top 11 RPA benefits in Healthcare -

  1. Simplification of operations
  2. Speedy execution
  3. Efficiency of scale and savings
  4. Fast roll-out
  5. Agile environment
  6. Higher order of automation
  7. Smart execution
  8. High degree of collaboration
  9. Analytics framework
  10. Strong governance
  11. Cognitive technology based self-evolution
  1. Simplification of operations: Facilitates automation of complex processes in the Healthcare Insurance domain, which is replete with high volumes of transactional and paper-based data

  2. Speedy execution: Facilitates an integrated deployment with a focus on moving towards an agile environment

  3. Efficiency of scale and savings: Results in cost savings in the range of 40-70% with a scope of high scalability of operations in Healthcare Insurance

  4. Fast roll-out: A 'severity matrix' ranking the candidates for processes automation helps to speed the RPA roll-out in the organization

  5. Agile environment: Facilitates speedy delivery of proofs-of-concepts in the range of two days to two weeks depending on the complexity of the process

  6. Higher order of automation: Enables moving from cognitive assessment to cognitive execution through the amalgamation of RPA, Analytics, and Case Management

  7. Smart execution: Enables smart delivery of tasks with a combined Services and Product-based approach to suit the Healthcare Insurance vertical

  8. High degree of collaboration: Integrated approach between Information Technology and Operational Technology divisions allows movement towards a highly collaborative workforce

  9. Analytics framework: Provides analytics based monitoring mechanisms, which maintain a central control on the iBots, their realignment to changing applications, and their performance, making the RPA ecosystem more robust

  10. Strong governance: Helps the Governance teams to facilitate, control, and audit the RPA operations in real-time and play an active role in measuring the RPA impact in terms of speed, TAT, and savings

  11. Cognitive technology based self-evolution: A robust blue print of the dissemination of the technology through the enterprise allows to gradually develop the knowledge-base from individual sources of truth for evolution of self-learning iBots through pattern analysis

RPA use cases in Healthcare and Insurance

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RPA use cases in healthcare

In summary

RPA helps the Healthcare Insurance sector reap immense value by augmenting other technologies such as OCR and AI/ML. With an accurate and speedy execution, enterprises in the sector achieve almost 40 - 70% savings through cost reductions.

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Topics:Robotic Process Automation (RPA)Banking, Financial Services, and Insurance (BFSI)DigitalIntelligent AutomationIntelligent Document Processing

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