Where possible, every insurer wants to take advantage of automation to improve business operations. Automation in claims management allows the case manager to focus on high-value tasks and increases the carrier’s efficiency, accuracy, and cost-effectiveness. Low-touch and no-touch processing are the two main techniques used to fulfill these goals. Here’s a quick primer on each approach, and the potential they offer.
Understanding low-touch and no-touch claims processing
Low-touch processing minimizes human involvement in repetitive, time-consuming tasks. It streamlines the claims management process by automating routine activities, allowing staff to focus on complex cases that require empathy, critical thinking, and decision-making. For example, low-touch processing can handle a simple claim for a routine knee replacement, but for a case involving cancer or a heart attack, a claims manager will be alerted to oversee the claim.
No-touch processing takes automation a step further. Advanced technologies like optical character recognition (OCR) and artificial intelligence (AI) algorithms work together, ensuring end-to-end automation of the claim without any human involvement.
- OCR can read, interpret, and process data from documents such as invoices, medical records, and forms. OCR converts different types of documents into machine-readable text, eliminating the need for manual data entry and reducing errors that occur during manual transcription.
- AI brings intelligence to automation. Machine-learning algorithms learn from historical data patterns, enabling them to make decisions within rules. In claims management, AI can assess claims, identify patterns, and predict potential fraud. In turn, claims are processed faster, and customer satisfaction is improved while fraud incidents are reduced.
Real-life impact for insurers and their clients
Both low-touch and no-touch processing reduce the margin for error. Automation ensures every claim is processed accurately, consistently, and promptly. And by automating repetitive tasks, carriers save time and resources. Instead of doing mundane work, skilled claims staff can focus on customer interactions, guaranteeing claimants are heard, understood, and supported throughout the claims process.
Think of a non-complicated pregnancy claim: using OCR and AI, an insurer can quickly process medical records, assess the claim, and make a decision. This leads to early identification of possible return-to-work opportunities, allowing the claims manager to make timely interventions. The employee can go back to work sooner, reducing the financial burden on them and their employer.
How to implement automation in claims management
Implementing automation in claims management requires a strategic approach. Some important steps to consider include:
- Identify problems. Pinpoint the pain points in your claims administration process. Delays in document processing and fraud detection are some common issues, but you need to understand your organization’s specific challenges.
- Internal buy-in. Share data and case studies with stakeholders to illustrate how automation can save time, reduce errors, and enhance customer satisfaction.
- Strategic implementation. Start with small, manageable tasks and gradually scale up. Implement OCR and AI tools where they will make the most impact, such as document processing.
- Leverage vendor tools. Many vendors offer specialized automation tools for claims management. Before deciding to make a purchase, request demos and talk to their customers to find out how satisfied they are with the tools’ performance and the vendor’s service.
- Consistent communication. Of course, all stakeholders need to be kept in the loop. Your staff will appreciate hearing progress updates on the automation initiative. It’s important to foster a sense of involvement and anticipation among staff members. Automation can return more of their most valuable commodity: time.
Efficiency and accuracy have always been the goal
Low-touch and no-touch processing are just the latest methods in the never-ending quest for efficiency and accuracy in claims management. By harnessing the power of OCR and AI, insurers can reduce costs and errors, while enhancing customer satisfaction and employee productivity.
With careful planning, any insurer can start this journey, ensuring that claims administration becomes a seamless, customer-centric process. To learn more, play the rest of our digital event: Automation in Claims Management
