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Solution

Enrollment 360 Digitized Solution

Reduce Quote-to-Card cycle time, lower operating costs, and ensure regulatory compliance.

 

Challenge

US healthcare payers today are seeking to simplify their complex enrollment and case installation processes, in order to reduce the ‘Quote-to-Card’ cycle time, and minimize delayed and incorrect claims processing. However, their continued dependence on manual data entry and enrollment management processes, combined with the lack of integration between disparate silo-ed systems, is impeding operational efficiency. The furnishing of inaccurate, incomplete applications also leads to delayed onboarding, as it necessitates rectification and follow-ups with third-party administrators and other stakeholders.

TCS Solution

Salient components of the solution include:

  • Data Integrator: Processes electronic data collected from multiple sources and ICR, and then scrubs, validates, and converts it into HIPAA 834 and other formats; segregates accurate records from incorrect ones; allows users to leverage self-service feature for log-in, file uploading, and error correction
  • Intelligent Character Recognition (ICR): Reads data, with data entry associates validating it; updates data processed by an Artificial Intelligence Machine Learning (AI & ML) algorithm
  • Robotic Process Automation (RPA): Updates the case installation screens; emails data-related errors to associates and tracks those via the workflow tool

Benefits

TCS’ Enrollment 360 Digitized Solution delivers the following benefits:

  • Reduced Quote-to-Card cycle time: Ensure convenient and secure onboarding, and shorten the cycle time for issuing enorllment cards to between 5 and 7 days
  • Higher operational efficiency: Reduce member enrollment costs by automating capture and loading of data; process huge data volumes smoothly; boost operational efficiency by as much as 45%
  • Enhanced customer satisfaction: Increase workflow transparency by gaining end-to-end visibility from pre-enrollment through enrollment

 

 

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