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Minimizing Costs, Maximizing Revenue, and Enhancing Customer Experience for Health Insurance Companies

Another factor important to health insurance providers is the improvement of operational efficiency. Not only are organizations able to decrease their process times through automation, but they can also reduce their overhead costs. In part, this is because automation allows them to improve their utilization of skilled individuals for more difficult tasks.

On top of this, organizations can also expect to reduce fees and fines, as some health insurance processes have Service Level Agreements (SLAs) enforced by the government that can result in penalties if they are not met.

How Important is your Bottomline: Decreasing Fraud and Increasing Revenue

A portion of this includes the reduction of fraud. The DOJ reports that fraud costs the health insurance industry over $100 billion a year. Through the proper implementation of IA, insurance providers can expect faster actions and decisions that will greatly improve fraud detection. This includes client data protection and the prevention of data leaks that can occur because of manual data handling, as well as an increase in compliance through the systematic automation of regulated activities.

The next benefit of intelligent automation is increased revenue. This often comes from the ability to introduce new products or services. With IA, new processes are possible that weren’t feasible before, opening the door to new revenue streams. By performing tasks on a larger scale, products and services can be innovated to include new features to attract a wider client base. There are more discoveries being made to provide new benefits and services to customers.

Through IA, health insurance organizations can offer reduced wait times and quicker turnaround, but the real increase in revenue comes from somewhere else. By leveraging machine learning and robotic process automation, it is feasible to create faster time-to-market solutions, which means you bring in more business. This is coupled with more opportunities for cross-selling. The end result is more business available to your customers, quicker. This equals more money.

Making the Customer Experience Enjoyable

Customers are happy when they can get the information they need quickly and accurately. By leveraging automation to augment the capabilities of a workforce, health insurance companies enable their reps to support a greater number of customers, and to do so with better quality. Practical uses of IA include answering customer questions in real-time, reducing time to fill prescriptions, and optimizing the underwriting process.

Improving the customer experience will require healthcare organizations to finally address the notoriously inefficient workflows between payers, providers and care recipients. Any process that can be re-engineered through IA can reduce the friction that can hamper the end-user’s experience. Claims adjudication is one example of these processes. Imagine the customer’s experience when a claim approval is reduced from days/weeks to mere hours, and process reduction times like that are achievable when Intelligent Automation is applied effectively.


Intelligent Automation presents an enormous opportunity for health insurance companies to begin tackling the industry-wide inefficiencies that drive costs and degrade customer experiences. From workforce optimization to regulatory protection, IA is a necessary step to improving the way you do business. It streamlines processes that not only deliver enhanced experiences to the customer, but do so in a way that generates new opportunities and streams for revenue.

Productive Edge continues to work with dynamic organizations in the health insurance industry to identify avenues where new products and processes can be implemented to transform their businesses.

Curious as to where you are on the journey to implementing IA? Check out our in depth infographic and see where your organization falls on the Roadmap to IA for Healthcare Insurance Organizations.

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