Claims Appeal Handling

When members submit a policy complaint or want to appeal a decision, one of several teams must review the case. Appeals are requested via email, fax, phone or through a web form. Information, including member name and complaint type, must be manually entered to start the appeal process. That’s time- and labor-intensive, and prone to errors — and any slowdown of an appeal can cost significant time and money. WorkFusion can extract data from emails using RPA and OCR. Information can then be routed to the right queue, and exceptions and unusual cases can be flagged for follow-up by your teams.

Companies leveraging this solution can automate 85% of the manual work involved in the appeals-handling process and achieve 99% data accuracy while also reducing handling time by 80%.