Automate Insurance Claims Processing

Automate Insurance Claims Processing

Man filling out Insurance Claim Form

AN HONEST EVALUATION. A PATH FORWARD.

It all began for this insurer with a candid evaluation of their existing claims process. They quickly determined that there had to be a better way. The claims document procedure was predominantly a manual, paper-based system. Sharing documents and collaboration between claims offices was limited at best. It was difficult for individuals to work out of the same paper claim file at the same time. It was clear a new electronic claim file process was needed. Claims management staff realized they needed a system that would not only allow for collaboration between offices but provide a secure repository for scanned documents. A well-structured yet aggressive plan to tame the volumes of incoming claims documents was needed.

These documents, received daily by mail or created in various offices around the state, contained a large mix of document types, sizes and those in all sorts of physical disrepair. Their traditional process required manual opening, prepping, and sorting of over 30 document types. A document scanning solution had not yet been implemented; primarily because claims documents are not clean and predictable, making prep for scanning a costly nightmare.

The objective was straightforward: to streamline the current paper-based process and create a workflow in which this mix of claims documents flowed smoothly and seamlessly from the mailroom through the claims process. The plan included establishing a centralized document imaging unit and routing all claims mail through this team.

THE CLAIMS CONUNDRUM.

Claims documents presented a particular challenge that was new to the existing scanning process. The claims documents were of mixed sizes, weights, orientations and conditions. They included color photographs, envelopes of various sizes and even larger boxed mail packages. The claims function required a solution that would:

  • identify and associate documents that come together in an envelope or package
  • associate an image of the physical envelope with the documents inside
  • meet aggressive timelines for making new mail available in the system to the claim reviewer

One option the insurer considered was to use traditional production level elevator scanners and manually prep and sort documents into 30 plus document types prior to scanning. Separator sheets would need to be inserted before each document type and a secondary separator sheet for the envelope. Needless to say, this approach was not very compelling due to the cost associated with adding more staff as a result of all the prep work.

As they searched for other solutions that would meet the requirements, this insurer turned to OPEX Corporation. Combining envelope content extraction with a scanner that would readily handle their wide range of claims documents made perfect sense to them. After a few conversations with other OPEX customers who heartily endorsed this strategy, this insurer purchased two AS7200 scanners integrated with two Model 72 Rapid Extraction Desks.

SCANNING…WITH BENEFITS.

Insurance Claim Form Pile

The new scanning process allowed a single scan operator the ability to automatically open the envelope, separate/scan documents and recognize envelopes as natural package separators. By having the machine do most of the work, the need for prepping the documents was greatly reduced.

What they found was that these OPEX universal document scanning workstations met their requirements easily – and since the complex prep and sort steps were virtually eliminated, they were able to continue operations without adding any staff. As a matter of fact, they added an entire claims scanning operation using the same number of cross-trained employees they already had! They were able to absorb a 35% increase in the volume of incoming documents to be scanned and entered into workflow, most of which had twice the indexing requirements.

In addition to the over 12,000 hours of labor saved for their claims staff, and the stacks of dollars saved in avoidable labor costs, this P&C insurance company received additional benefits from their OPEX hardware and software solution that were not insignificant:

  • time savings in having the ability to select a color option during scan time
  • labor savings with the ability to scan, auto-rotate, and read thermal receipts
  • cost savings in postage and courier services (no longer needing to ship physical files between offices)
  • consistency across all 15 district claim offices
  • control, compliance and security

According to their Document Systems Manager, “by purchasing the OPEX solution in place of adding to staff, we anticipate saving more than $264,000 over a 4-year period.”

Not only has this insurer saved significant time, labor, and material costs; they have also vastly reduced their access time in retrieving claim documents, resulting in improved service to the customer. “Our claim staff has been able to focus more on settling claims rather than administrative tasks related to paper handling,” said their Senior Systems Programmer. Formerly, adjusters would have file storage boxes full of supporting documents under their feet, or have to chase down documents from any number of filing cabinets. He continued, “not only have we seen those positive changes, but we have also improved camaraderie and collaboration between branch offices. With all claims documents now electronic, claims representatives work more closely together and may share each other’s workload. For example, remote offices can collaborate on an auto accident that occurred in the easternmost part of the state for a customer who resides on the west side of the state. These claim documents are shared almost instantaneously.”

MOVING FORWARD

They most recently added a Falcon Transportable as a backup unit. Being housed at a satellite location, the Falcon Transportable has been set up to scan back file documents. As it is also transportable, this universal scanning workstation is easily shipped to a claims processing location to support local scanning during a large claim event.

If you can identify with this insurer and desire to achieve significant benefits from an OPEX solution moving forward, email us at info@opex.com or pick up the phone and give us a call. If you would like to hear more about this or other similar stories of process improvement provided by OPEX, simply visit our website at www.opex.com