Efficient claims management is integral to customer satisfaction and loyalty. Therefore smart insurers focus on transforming their claims processes through automated claims administration solutions. They evolve over their traditional manual processes that could be error-prone.

WNS’ eAdjudicator that automates the end-to-end adjudication process of myriad claims is based on robotic process automation. It automates the matching of claim parameters against a rule library, and has built-in validation steps to ensure accurate processing, thereby increasing operational efficiencies.



Features:


 

Works as an independent and flexible platform

 

 

Bolt-on to legacy adjudication engines

 

 

Streamlines processes and automates workflows

 

 

Allows straight-through processing when needed

 

Automates the retrieval and updation of data with back-end systems or screens

 


Key Benefits:


Significant efficiency gains achieved without major system / IT upgrade

 

 

Accelerated, error-free claims processing

 

Rule-based automation reduces anomalies in human judgment

 

Reduced revenue leakage from inaccurate claims settlements

 

 

Reduced claims cycle time

 

 

Lower total cost of ownership

 

 

Highly scalable through parallel processing

 

 

Ability to integrate regulations to be 100% compliant

 

 

Ensures enhanced customer experience

 

 



Insurers Can Automate Claims Settlement Process with eAdjudicator

 

The Industry Challenge:

The claims settlement process for insurers is often severely affected by delays, revenue leakages and frauds, thus rendering it highly ineffective. One of our top Health Insurance clients faced a similar challenge.

How eAdjudicator Helps:

WNS’ eAdjudicator tool automates the adjudication process to help insurers expedite their claims settlement process, while reducing the possibility of revenue leakages and frauds.

This tool consists of a set of built-in rule-library based codes, for several complex scenarios, especially for exceptions.

Business Benefits:

eAdjudicator enables a client to automate its claims settlement process and derive the following benefits:

  • Improve productivity significantly. eAdjudicator ensured a potential productivity gain of 50 percent for one of our Health Insurance clients

  • Reduce revenue leakage by eliminating the possibility of erroneous processing through automation of manual processes


This is a Proof of Concept

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