Medical shortfall insurance case study

Medical Services Case study

Medical shortfall insurance services

Case study details

For this case study, our client is a Medical Aid extension service provider.

The Customer provides healthcare extension services to medical aids. As ab additional service to normal medical aid short claims.

Applications are received via paper and fillable PDF documents. Application types consist of New registrations and claims

The challenge

Consultants used a very remedial capture solution to import the scanned and email documents. The email attachments had to be printed or viewd in a second screen to enable dat reading off screen and paper. The consultants could then start to work on the indexing of the documents to a spreadsheet.

Turn around time for these claims were hours as the manual processes took up a lot of time. Once the documents were indexed, they were then exported as csv. The files were them manually imported into their CRM system MS Sharepoint.
Turn around time on claims was between 72-96 hours

Solution

DCM CORE was implemented in an on-premise solution to capture, classify, and extract and validate insurance documents.
First step was to consolidate and automate the incoming documents and the conversion to a standard processing format. Automated email extraction was configured whereby multiple email mailboxes could be monitored. New email bodies and attachments are automatically extracted and converted to PDF files for further processing. Via the central importing module all scanned documents and email are processed and batches are created without any user input.

Document classification and template matching is applied to the documents to assist with the indexing process. Documents are presented in a central capture interface with all documents securely store on the server and no local document processing is required.
Consultants can view the imported documents and perform index and data validations. Documents that were successfully classified and validated will be automatically saved for further processing

The system easily processes the current volumes of +/- 5000 emails with attachments per day. The processed documents have a 95% pass through rate, in other words 95% of the documents received are processed without human intervention.
On completion the documents are automatically ingested into their document management system and insurance workflow system
Turn around time of most of the documents is 2 -5 min per claim that must be indexed manually
This allows for a lot of time staff members can then spend on helping the business grow in different ways. DCM has not only saved time in processing of the documents but increased the speed of payouts to the claimants

Benefits

With DCM Core any file or document could be easily processed
Increasing staff productivity and time management
Delays looking for files and retrieving them was decreased by hours and sometimes days.
The paperless office saved the storage, printing and copying costs, was almost eliminated

Join us here

Posted in Quick links.

Leave a Reply

Your email address will not be published.