Why Insurance Companies Must Consider Claim Processing Workflows

Every business organizes repetitive tasks into a sequence of steps, which we call workflows. Simply put, workflows define how work gets done in an organization.

Owing to the scale at which organizations operate, even a small change or improvement in this sequence of steps can create efficiencies, and save time and cost.

Take the example of an insurance company that is processing insurance claim forms. Processing manual forms, reaching a decision to accept or reject the claim, and issuing a payout to the customer are various steps in their process.

It involves several people validating data across multiple documents. Claims usually include processing unstructured data from reports, images, cost estimate proformas, emails, and other supporting documents. Manually sifting through information and processing documents from multiple sources is a complex activity. Any error, delay or omission in any of the steps delays payouts to customers and may result in unhappy customers. 

That's where automated claim processing plays a role—it increases the speed of claim processing while improving accuracy. Ultimately, it helps keep customers happy and takes the burden of manual processing away from employees!

NEW GUIDE: How to become a paperless company in 90 days


The art and science of building efficient business workflows 

Workflow efficiency is the measure of time and effort consumed in completing a recurring process or activity sequence.

Why is workflow efficiency important? An efficient workflow eliminates process redundancies and improves productivity. As a result, employees spend more time on productive work, leading to employee satisfaction and increased efficiency.

According to Gartner, one approach to creating workflow efficiencies is the automation of events, processes or tasks that are time-consuming or repetitive, such as the automation of steps to execute claims processing workflows in the insurance industry.

Why automate insurance claims processing workflows?

Claims processing is a critical function in any insurance company as it is the workflow that delivers the promised financial benefits to the insurance policyholder. The speed and convenience of claims settlement impact the insurance company's performance and reputation.

But insurance claims workflows tend to be slow, prone to manual errors, and susceptible to fraudulent claims. According to Coalition Against Insurance Fraud, the U.S. insurance industry is estimated to lose $80 billion annually due to fraudulent claims. Clearly, it is mission-critical for insurance companies to ensure that claims process workflows are efficient, with high levels of accuracy. 

Workflow automation optimizes the steps in the claims processing workflow, making it speedier. Automation empowers employees, relieving them of paperwork and allowing them to focus on customer engagement and other more value-added work.

Let's look at three of the most important reasons why insurance companies cannot afford to ignore automated claims processing workflows.

#1. Eliminate expensive and time-consuming manual data entry

Claims processing is typically document-intensive. Data from various forms and documents must be manually entered into the insurance company's backend system—a process that is time-consuming, expensive and error-prone. 

Automated data extraction technology eliminates the inaccuracies and inefficiencies of manual data entry. Critical data from the submitted documents, such as name, billing address and more, are automatically extracted, streamlining claim processes and reducing the overall likelihood of errors.

Manual data processing is a high-resource, high-cost activity, so reduced manual intervention yields significant cost savings.

At DRS, we leverage industry-leading Machine Learning (ML) technology through our partnership with Hyperscience

The Hyperscience Platform offers human-centered automation that intelligently streamlines your document processes from data entry to actionable reporting insights.

The platform delivers the most accurate data extraction in the industry.

It extracts data from complex documents and difficult-to-read papers, including handwritten forms, PDFs, images, emails and more. 

The technology uses modular Code Blocks—or components that can be independently developed and deployed by business users. These Blocks help us customize your insurance workflows to enable claims processing with ease and speed.

Our automated claims processing solution can validate submitted information against master data, confirm line items sum to total charges and then package and send a claim for approval or further review. 

Hyperscience has delivered over a 67% increase in accuracy of data processing, up to 10x faster processing time, and a 90% cost reduction with more efficient and streamlined processes.

 #2. Validate completeness of the claims application

Customers must submit several documents to claim insurance benefits, and the list of documents varies on a case-to-case basis. The document requirements are complex, so many applications are incomplete and get rejected. The insurance company then asks consumers to submit additional information or supporting documents before processing the claim. The result is that consumers face delays in receiving the payouts. Such a long-winding process also reduces efficiency and increases operational costs.

DRS provides advanced document processing technology with built-in, real-time reporting to understand and locate bottlenecks in your claims processing. The ML-based Hyperscience platform can automatically assign supervision tasks such as sending incomplete claim applications to your exception-handling system or specific teams for review. Pre-built or easily configurable automation solutions optimize claims processing workflows. The platform also provides auditors with complete visibility with audit trail information and gives consumers transparency about the status of their claim processing.

#3. Reduce expensive real estate costs

Insurance companies must adhere to strict records retention schedules and maintain original paperwork for future reference. Physical archival of large volumes of documents is expensive, as it requires extensive storage space. This problem has been solved by the increased adoption of digitization in the insurance industry.

Talk to DRS for digital mailroom services that digitize documents at source, help with records retention and compliance, and host legacy records on a cloud environment, saving substantial costs related to storage space. 

INDUSTRY REPORT: Top digital transformation innovations changing your industry

DRS Imaging: Our workflow automation experts are here to help

With our extensive experience in workflow automation, we integrate with your document-intensive processes and workflow systems to provide accurate, actionable data where you need it most.

Our partnership with Hyperscience empowers us with industry-leading ML technology for scalable, enterprise-wide automation, not a generic template-based approach. 

Leading insurance providers are leveraging our intelligent automation solutions to reduce costs, mitigate risks of manual errors, and improve productivity.

Contact DRS today and gain a competitive advantage with automated claims processing workflows.