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Case Study

Robotic Process Automation in Healthcare

  • Challenge

    A health insurance company, with business and private clients, deals with over 30,000 hardship cases per year that are digitally filed in one inbox. This inbox is processed manually, requiring highly trained staff and employment of seasonal workers from November to March. The processing of one claim takes an employee approximately 30 minutes and relies on a number of business rules.

  • Solution

    SPS processes the digitized claims in the in-tray, deploying OCR and RPA. In the first step, OCR is deployed to read the data from applications, payment documents, and other attached documents in order to prepare these in a CSV file. If all of the necessary data and documents are present, the robots start processing under strict observance of business rules. The robots work on the existing systems and are therefore able to notify staff should they stumble on irregularities.

  • Benefits

    The benefits to the client include:

    • Reduction of manual processing by 60%.
    • Seasonal employees are no longer needed, as robots support the process 24/7/365.
    • Average handling time per claim has been reduced by 50%
    • Process accuracy and quality have been improved as human processing errors are removed.
    • Operational costs have been reduced.

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