i3claims - Intelligent RPA for Insurance Companies

End-to-End Claims
Automation Solution

With increasing complexities and evolving consumer demands, digitisation of the claims process has become essential for insurers to ensure fast settlement & payment of claims as well as drive customer satisfaction and set standards of service. However, traditional claims processes involve intensive document-driven operations and the processing of non-structured data in multiple formats/nomenclature, making it difficult for insurers to process claims efficiently and quickly.

Current Challenges

Challenge

Traditional claims processes are manual and capture very limited data. This makes the process inconsistent and non-trackable, resulting in payment leakages

Solution

i3claim helps in capturing significantly more data-points in much lesser handling time. It reduces the extent of manual data capture and human errors in the entire claims process by more than 60%, making it much faster and extremely scalable.

Challenge

Data comes from multiple channels such as papers, electronic documents, images, and emails in a non-structured format.

Solution

i3claim accepts data input from a variety of sources like Hospitals, Pharmacies and Diagnostic centres. It extracts, classifies, and standardizes non-structured data present across multiple documents.

Challenge

Tariff agreement plans between insurers and hospitals are complex, data-heavy and complicated enough to be usable by only medical professionals

Solution

DigiTariff converts provider tariff agreements into structured data sets or excel sheets. Using DigiTariff, insurers can capture all items of a tariff agreement, while also standardising the expense items for price-comparison and analytics. The overall effort and cost would be 75% lower than the completely manual process.

Challenge

Due to manual processing, the average discharge authorisation is anywhere between 1-4hrs.

Solution

i3claim reduces the claims process to a single queue, by automating several parallel activities. This improves efficiency and leads to a reduction in cashless discharge time from 4 hours to less than 30 minutes for 90% of the cases

Challenge

Manually processing of invoices and complex tariffs lead to payment leakages to the tune of 3-10% of claim amount for every claim.

Solution

AI-assisted processing covers accurate capture of Non-payable and tariff comparison on 60% of the line-items. This has led to an average of Rs. 200-5000 savings per claim compared to manual processing.

Manual capture of limited data

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Challenge

Traditional claims processes are manual and capture very limited data. This makes the process inconsistent and non-trackable, resulting in payment leakages

Solution

i3claim helps in capturing significantly more data-points in much lesser handling time. It reduces the extent of manual data capture and human errors in the entire claims process by more than 60%, making it much faster and extremely scalable.

Non-structured Data

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Challenge

Data comes from multiple channels such as papers, electronic documents, images, and emails in a non-structured format.

Solution

i3claim accepts data input from a variety of sources like Hospitals, Pharmacies and Diagnostic centres. It extracts, classifies, and standardizes non-structured data present across multiple documents.

Complex Tariff Plans

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Challenge

Tariff agreement plans between insurers and hospitals are complex, data-heavy and complicated enough to be usable by only medical professionals.

Solution

DigiTariff converts provider tariff agreements into structured data sets or excel sheets. Using DigiTariff, insurers can capture all items of a tariff agreement, while also standardising the expense items for price-comparison and analytics. The overall effort and cost would be 75% lower than the completely manual process.

Discharge Authorisation

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Challenge

Due to manual processing, the average discharge authorisation is anywhere between 1-4hrs.

Solution

i3claim reduces the claims process to a single queue, by automating several parallel activities. This improves efficiency and leads to a reduction in cashless discharge time from 4 hours to less than 30 minutes for 90% of the cases

Payment Leakages

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Challenge

Manually processing of invoices and complex tariffs lead to payment leakages to the tune of 3-10% of claim amount for every claim.

Solution

AI-assisted processing covers accurate capture of Non-payable and tariff comparison on 60% of the line-items. This has led to an average of Rs. 200-5000 savings per claim compared to manual processing.

i3claim is an intelligent automation solution that provides end-to-end claims automation.

It extracts, classifies, and validates over 300 data points in every claim document, reducing manual efforts, lowering costs by 50-80%, and making an accurate decision on every claim with a short turnaround time of 5 minutes.

Modules