Highmark Health Processes 2.1 million COVID-19 Claims with Intelligent Automation
"A digital worker checks the file every 15 minutes. Instead of days, members are getting an answer in minutes. When a member has an important request, they don’t want it on Friday, they want it now. And with our digital workforce, we can deliver.”
Based in Ireland, Laya Healthcare is the second largest insurer in the country with more than 600,000 members. The company is committed to providing the best possible care for members. Even their name, Laya, stands for “Looking After You Always.” But when it came to looking after claim assessments and member requests for documentation, Laya wanted to deliver a higher level of customer service. And they did, with help from intelligent automation.
Laya’s mission is to deliver the best possible health outcomes for its members by providing quality insurance coverage and excellent service. However, with over 600,000 members, Laya had to process a high volume of claims from hospitals and healthcare providers — 30,000-40,000 to be exact. It’s no wonder that existing staff found it challenging to process these claims in a timely manner.
And when Laya’s members required documentation relating to healthcare coverage or claim payments, it was difficult to get the information quickly. For instance, if a member rang the call center requesting policy documentation for a healthcare need, the customer service associate (CSA) had to send an email to a colleague. Then that person would note the request and generate the documentation. Since the documentation could go back several years, they often had to collate more than 50 pages per member. This could take up to a week, a potentially negative experience if the member needed information urgently. Laya knew there was a better way to look after their members.
Processing high volumes of claims and member requests was a laborious and time-consuming job for its employees. So Laya deployed a Blue Prism digital workforce to pick up the slack, and the results have been impressive. Simpler claims are now assigned to digital workers, who rapidly assess and prepare them for payment. As a result, the digital workers have cut the time to process each claim by 70%. What used to take 6 1/2 minutes now takes just two. Applied across the large volume of claims Laya receives every month, this has already returned 24,280 hours back to the business. And employees can now refocus on more complex claims and higher-value tasks like speaking directly with members and providing coverage details almost immediately.
Now, when a member calls Laya, the CSA can quickly enter the request into an Excel spreadsheet. A digital worker checks the file every 15 minutes, notes the request, generates the documentation, and sends it to the member. Instead of waiting up to a week, members get the critical information they need in a matter of minutes. Better yet, they know that Laya is committed to looking after them.
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