Let’s face it: filing an insurance claim doesn’t rank high on the bucket list for most of us. It’s a necessary evil when things go wrong in life. But the insurance claims process doesn’t have to be miserable. Leading banking and insurance organizations have increased their business agility, competitiveness, customer engagement and profitability by taking steps to modernize the insurance claims process – and their customers are breathing a sigh of relief.

Think about your claims process for a moment. Are your first-notice-of-loss (FNOL) and adjudication workflows mired in manual, paper-based tasks? Are you concerned about data errors causing regulatory compliance hiccups? Or are claims processing inefficiencies spiraling to frustrate your employees and your policyholders?

Fortunately, there’s a clear path toward better management of the volume and complexity of claims, as well as the customer experience. Here are 5 steps you can take to modernize your insurance claims process.

1. Go mobile

Your customers are on-the-go, and fast, frictionless processes are the order of the day. If they had the time, here’s what your customers would be telling you:

Allow me to open an app or visit an easy-to-remember website to initiate the claims process. Don’t require me to know and provide a lot of information about my policy – the fewer pieces of data I have to enter, the better – and don’t make me enter what I do know multiple times. And whatever you do, don’t make me start over if I have to stop!

Allow me to take a snapshot of driver’s licenses, insurance cards, property damage, or whatever document the app is requesting. Then automatically and immediately display the data from these documents on my device for confirmation. Tell me what the next steps are, and when I should expect to complete them.

2. Automate data entry

Data entry contributes significant cost and delay to the claims process. According to Strategy&, “Claims represent the largest single cost to insurers, with up to 80 percent of all premiums spent on claims payment and associated handling charges.” Manually entering claims data into claims adjudication systems comprises a good share of that 80 percent. Some claims have more data to enter than others, but in the U.S., a CMS-1500 or UB-04 medical claim has hundreds of fields to extract on a single form. Doing this manually increases costs and errors and delays claim payment.

Why not use AI-based cognitive document automation (CDA) to machine-learn the type of claim and the claim’s layout and intelligently locate and extract data from the claim, freeing up humans to process exceptions and perform other value-added tasks.

3. Robotize data acquisition

Let’s not forget all the small tasks that claims processors have to deal with for each claim during the adjudication process. Checking member contact information and eligibility, verifying member authority to open a claim, confirming that a policy is in force, ensuring adequate data to open the claim, opening the claim case—all these tasks require manual work by claims personnel that slows the process.

Robotic process automation (RPA) combined with a workflow and business rules engine can automate the execution of these manual, repetitive tasks, and provide the flexibility to process the exceptions and human steps that inevitably occur.

4. Engage your customer

Customer engagement starts at the mobile device — or any engagement channel the customer prefers, such as a website or email — but doesn’t end there. Your customers want to know the status of their claim throughout the claims process and what to expect next: Has the claim been opened? What information do you still need from me? When will the process complete? When can I expect to be reimbursed?

A case management system can deliver this type of communication, automatically through the customer’s channel of choice, based on the status of the case at any point in time.

5. Optimize the process

If you’ve made it this far, you’ve automated the claims process and made it easier for customers to engage with you. Now it’s time to apply process intelligence and analytics technologies to gain visibility into the channels, personnel, costs and time required by the process; this information empowers you to continue doing what’s working and improve what’s not. Visualize processes, identify root causes of bottlenecks, and identify problem areas that need optimization.

Applying process intelligence to claims processing ensures continuing process improvement around the metrics that matter: cost per claim, time per claim, claims personnel productivity, and customer engagement channels used, to name a few.

Learn more about how Kofax delivers all 5 of these ways to help you modernize your insurance claims process. Download your free white paper “Powering the Insurance Claims Process with Information Capture and Intelligent Automation.”




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