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Majority of Health Plans Anticipate Claims to be the Largest Area Affected by Automation Intelligence Software

CHICAGO (July 29, 2019) – A flash poll conducted by Baker Tilly Virchow Krause, LLP (Baker Tilly) indicates more than half of health insurance organizations anticipate the claims function to be the area of their organization most impacted by robotic process automation (RPA) and other forms of automated technologies.

“The claims process often includes several application components within diverse systems, which is why manual processes are commonly established to manage data integration. With the threat of inefficiency and possibility for human error imminent due to these complex systems, many health plans are looking to make investments in RPA,” Michael Patti, Baker Tilly principal in the healthcare consulting practice, said. “Because the current state of the claims process varies between health plans, actionable ideas to automate portions of this function can range across the spectrum. Some areas that can often benefit from automation include eligibility and benefit inquiries, pre-authorization checks, data intake from various inbound claims channels, claims edit processes, supplemental documentation requests, and fraud waste and abuse audits.”

“One of the major objectives of digital transformation is to increase operational efficiencies in organizations,” Waqqas Mahmood, MBA, PMP, P.E., Baker Tilly director of advanced technology and innovation, said. “Not only does RPA increase efficiencies for the end-user, but the implementation of these technologies is also considered to be a seamless process. Unlike establishing a new CRM software, automation intelligence technologies integrate with your existing IT infrastructure so there is no need to re-establish your organization’s entire IT ecosystem.”

Baker Tilly recently held an educational webinar, Understanding digital transformation for health plans: robotic process automation as a strategy, to assist health insurance organization professionals in learning about how insurers are using RPA technologies to enhance their digital transformation, creating operational efficiencies, engaging customers and becoming a data driven organization.

The webinar presenters discussed:

  • The current RPA landscape and relevant use cases within the health plans industry
  • Incorporating RPA technology into complex business processes
  • How organizations are navigating challenges with RPA

A recording of the webinar is available at bakertilly.com/insights/understanding-digital-transformation-for-health-plans.