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66% decrease in the cost of processing claims

Business Effeciency icon

Average 9.3hrs per day saved in manual claims processing

Remarkable impact on operational efficiency and cost savings

Latrobe Health Services (LHS), a not-for-profit registered private health insurer with more than 90,000 members across Australia, embarked on a critical journey to address a significant operational inefficiency impacting their service delivery and operational costs — manual processing of paper hospital claims.

The challenge

Before engaging Canon Business Services Australia (CBS), LHS was entrenched in a manual, labour-intensive process for handling claims. Staff dedicated extensive hours to data entry and verifying claims against member policies.

This method was fraught with delays and a higher probability of errors, detrimentally affecting hospital provider satisfaction. It consumed disproportionate employee time and underutilised staff skills, highlighting a pressing need for more efficient, agile operations.

“This initiative was a significant shift in mindset for the business. Essentially, our team members were operating in a dual capacity – as manual data entry clerks and claim assessment experts, effectively processing each claim twice.”

Brendan Over, LHS Program Manager

“The challenge of manually inputting data, particularly for statutory obligations like Hospital Case Mix data, is one that our business and likely every player in the industry faces,” he says. “It’s a universal struggle to balance these necessary yet non-value-adding tasks with the imperative to streamline and optimise our operations for the benefit of our members and the organisation.”

The solution

LHS and CBS’s collaboration began with a comprehensive analysis of LHS’ operational environment and core PHI system processes, identifying key areas for digital transformation. This work was grounded in LHS’ strategic vision, which is aimed at modernising core systems and infrastructure to support the fund’s growth and pave the way for digital advancements.

LHS had already embarked on a modernisation journey, achieving a 70% automation rate for electronic claims by early 2020. The relationship with CBS had evolved from an initial engagement for digitising inbound and outbound mail, setting the stage for tackling the more complex challenge of automating manual paper claims received from hospitals.

“Integrating a new partner into our core application demanded innovative solutions and significant effort. Despite the complexities, we never felt unsupported by CBS. They were truly ‘boots on the ground’ alongside us, contributing networking resources and much more,” explains Brendan.

Any recommendations would have to fit the existing infrastructure seamlessly rather than simply being a technological add-on. CBS’s solution implemented a blend of robotic process automation as a service (RPAaaS) and intelligent capture customised to address LHS’ unique challenges.

“We chose RPAaaS for its ability to automate repetitive tasks, with the added value that it’s an ongoing Platform as a Service support model that lets LHS access the operational tools it needs, when it needs them. The service allows them to scale when needed, work from anywhere, and boost security without investing in additional hardware or the burden of monitoring, maintaining, and updating a development platform,” explains Lukas Placek, CBS Commercial Account Manager.

“Intelligent Capture helped extract and process data from various formats and sources. This combination ensured the claims process was faster and more accurate, reducing the likelihood of errors arising from manual processing,” he adds.

The CBS team meticulously planned the implementation phase to minimise disruption, working closely with LHS to ensure staff were trained and comfortable with the new system. This included hands-on training sessions, comprehensive support materials, and a phased rollout that allowed for adjustments based on real-world use.

“Working with CBS has been incredibly smooth and straightforward. Having Jaya as a project manager was invaluable--- his hands-on approach and in-depth involvement in analysing files and strategising the best path forward made a notable difference. It’s rare and refreshing to work with someone who’s not just orchestrating but deeply engaged in the solution” says Brendan.

“Donna Nehme, our CBS account manager, has also been exceptionally supportive, expertly navigating the operational realities we face and the new processes we aim to introduce. Her consistent presence and valuable input at every stand-up meeting make a significant difference,” he added. “Likewise, Lukas is always prepared to mobilise resources and provide an escalation point when needed. CBS stands out as a remarkably easy and efficient vendor to work with.”

The results speak for themselves

Operational efficiency.

Post-implementation, LHS reported a dramatic improvement in claim processing times. What once took several days is now completed in hours, if not minutes. CBS’ solution reduced operational costs and allowed LHS to handle a higher volume of claims without compromising quality or accuracy.

Team empowerment.

Automating repetitive tasks has liberated LHS employees from manual processing, allowing them to focus on more strategic and impactful work, boosting job satisfaction, enhancing their capacity to deliver exceptional service to members and fostering a culture of innovation.

“It’s a monumental leap forward for us. It’s not just about efficiency. It’s about empowering our staff to work within their areas of expertise, enhancing both productivity and job satisfaction.” Brendan says.

Enhanced member experience.

LHS hospital partners have directly benefited from the efficiency gains, enjoying faster and more reliable claim settlements. This improvement has bolstered LHS’s reputation as a responsive and trustworthy health insurer, boosting partner satisfaction levels.

Strategic modernisation and continuous improvement.

LHS’ journey to digital transformation is part of a broader strategic vision, aiming for continuous improvement and further technological advancements. The success with CBS has laid a foundation for future projects, including an automated solution for Extras claims, promising even quicker processing times and enhanced service delivery to members.

Cultural shift and future outlook.

Introducing this technology has marked a significant shift in the LHS operational team. There’s a growing enthusiasm for innovation, with the team actively proposing new ideas for the robotics program. The scalability and adaptability of CBS’ solution mean that LHS can adjust to varying demands, realising increased benefits and ROI from the service.

Quantifiable impact.

Automation has proved a game-changer for LHS, saving an average of 9.3 hours per day in manual keying for paper hospital claims. This efficiency translates into a 66% decrease in the cost of processing claims during peak periods, showcasing the project’s remarkable impact on operational efficiency and cost savings.

To find out more about Canon Business Services’ automation and transformation solutions, get in touch today.

25+ years of experience

95% customer satisfaction rate

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