Workers’ Compensation Provider Expedites Claims Processing and Payouts
A Case Study
Client Overview
With operations coast to coast, our client provides workers’ compensation insurance and services for America’s small businesses with the goal to understand and meet the needs of independent, entrepreneurial companies.
The Challenge
Our client set a goal in place to become one of the top workers’ compensation providers across the nation. However, their “seasoned” claims infrastructure was holding them back. Their existing claims systems forced employees to jump between applications searching for policies, determine if fraud was at play, understand the payout structures, and obtain all the proper information to submit for approval. Not exactly an ideal setup for our client’s claims adjusters.
To help them find a replacement, our client looked for a partner that would be able to successfully get them up to par, and beyond, against the competition. It was also integral that the partner would understand the insurance industry and processes to follow industry standards.
Our Innovative Solution
To ensure the provider would be happy with our solution, we made sure the following requirements were met:
- Out-of-the-box functionality
- Streamlined processes process
- Enable better customer service
From this, we knew the IBM Digital Business Automation platform would be a perfect fit as the environment where we’d implement an intelligent document processing (IDP) solution to work with it. We approached this project in three stages:
1. Integration – For the integration stage, we made sure to integrate IBM DBA with the client’s policy administration system, Duck Creek, and other enterprise systems. As part of this process, we made sure the new environment could handle the variety and scale of content that came in.
2. Migration – Next, for the migration stage we leveraged our own tool, Migration Manager to easily migrate content to the new claims system.
3. Capturing Content – Lastly, we integrated IBM Datacap and IBM FileNet P8, part of the IBM DBA suite, for speedy ingestion and set up OCR, document classification, and document indexing for all claims submissions. IBM FileNet also ensured security for all documents.
From there, claim and document data is extracted and passed to Duck Creek as their claims system. This enabled the ability for users to link to documents from Duck Creek or have direct access to document folder
After the project was completed, our client saw many benefits including faster claims payouts, better user experience, and happier customers.
Technology Used:
- EIBM Digital Business Automation Platform
- EPyramid eXpeditor
- EAgile eXporter
- EMigration Manager
Our Exceptional Results
Payout Claims Faster
Seamless System for Employees & Customers
Platform Allows for Continuous Process Improvement
We helped our client achieve faster claims processing and payouts.
Imagine what we can do for you.
At Pyramid Solutions, we aim to help organizations manage content better. If you find you’re being held back by inefficient business processes or an old system, reach out to see how we can leverage our technology and expertise to help you move forward.