CASE STUDY

Reimagining claims processing through automation

Care providers submit documents in thousands of different formats

A Top 5 US Insurer processes hundreds of thousands of complex claims each year for their Long Term Care business. Care providers submit invoices and accompanying forms that outline the details of a claim, which need to be classified and understood in order to be paid.

The care invoices are typically faxed, or scanned and emailed between providers – making the documents messy and highly inconsistent. Thousands of different care providers, agencies and independents can send information in totally different formats. Despite existing success with RPA across the business, traditional technologies were unable to help understand these complex documents. 

 

Flexible configuration enables a single approach

Instabase worked closely with their Claims business to rapidly develop a prototype for understanding their Long Term Care Claims in only 5 weeks. This involved training a classifier module, configuring a powerful extraction solution and building an end-to-end app. We integrated straight into their existing workflow tool and aligned to their business rules and policies. 

 

Meaningful impact on cost and experiences

The overall process and architecture continues to run as before but with substantially fewer operators required to manually understand the documents, as Instabase has propelled them forwards in their ability to serve customers faster – reducing the overall Average Handling Time down from 10 days to 2 days.

This included 100% accuracy in classifying between different invoice providers, and 78% automated success in extracting the fields they needed.