Improving the Insurance Customer Experience with Ephesoft Smart Capture®

Improving the Insurance Customer Experience with Smart Capture®

In 2017, written premiums for the insurance industry in the United States totaled $1.15 trillion (source: Insurance Information Institute). With over 2.6 Million people employed in the insurance sector, competition for business is intense. According to the National Association of Insurance Commissioners, there are approximately 6,000 domestic-US insurance companies in business. With today’s ever more discerning consumer, it is critical for insurers to provide a high level of customer satisfaction to ensure a high level of customer retention as well as attract new policyholders.

In insurance, like many industries today, it is almost impossible to differentiate on price. The total customer experience is something that insurance companies do consistently cite as a key differentiator to the existing and prospective customers.

With competitive landscape cutting premiums to the bone, insurance companies are seeking other areas of the business where costs may be saved without compromising the total customer experience. The operational aspect of insurance claims processing makes insurance companies ideal candidates for efficiency gains and cost savings through Smart Capture®. Let’s look at three ways Ephesoft Transact can positively impact claim processing within different sectors of the insurance industry.

Pay Claims Faster At A Stressful Time

Making a claim against a homeowners’ insurance policy is a stressful experience for the policyholder. Flood, fire or wind damage, cause (at the very least) inconvenience and (at worst) temporary relocation and loss of articles while home repairs are made. It follows that the faster a claim is processed – decisions finalized, payments made and funds transferred – the better for the policyholder.

House damaged in landslide after floodWith Ephesoft Transact, insurance companies can automate content process of claim ingestion and review, by accelerating the access to claim-related documents and customer correspondence. Through a combination of supervised machine learning and rules-based logic, Ephesoft Transact automatically categorizes, separates and extracts data from insurance documents, whether they are emailed, faxed or mailed and scanned to the agency’s intake site.

Insurance companies that adopt a Smart Capture® solution can eliminate the need for barcode application, document preparation and manual data entry. On average, the implementation of intelligent capture software improves processing performance by 80%, thereby decreasing the time taken to process a claim, just when the customer needs it the most.

Empowering Customers To Submit Claim Documentation Anywhere

Hundreds of thousands of auto insurance policyholders elect to include roadside assistance with their insurance contracts. If you’re one of the lucky few that haven’t had a car towed after a blown tire, stalled engine or traffic collision, you may not realize that the resulting bill from a tow is typically printed or written on the spot and handed to the driver.

Towing Car

To make a claim for roadside assistance or car towing reimbursement, the automobile owner often must scan, email, fax or physically mail the paper bill to their local agency. It is a tedious process that has the potential to delay claim processing.

Ephesoft Transact improves this claim submission process by providing a capture tool for auto insurance companies that enables their customers to capture images of bills or receipts with their smartphone and immediately submit the documentation as addendums to claims against their insurance policy.

Removing manual paper form submission from the claim process empowers policyholders, reduce the risk of frustration over lost or misplaced receipts, and expedites process for the insurance company. Ephesoft’s mobile SDK for embedding mobile capture capabilities into an organization’s existing app – can save insurance companies time as well as increase policyholder and app user satisfaction.

Reduce Rework By Getting It Right the First Time

In the healthcare industry, insurance claims against a policy can be approved, denied or rejected. A rejected claim is one which contains errors and is returned to the biller (the medical provider) or to the policyholder (the customer) for correction. Similarly, denied claims often contain errors and incorrect information which are overlooked in the claims review and data entry process.

When a denied claim is challenged due to error, the claim may be appealed and sent back to the insurance company for re-review. It is a time-consuming process – causing frustration for the customer, delayed reimbursement for the medical provider and adding cost to the operation of processing that claim. As such, collecting and processing a “clean” claim – one without error or missing information – is of crucial importance for the insurer.

Clinical Administration

Deployed at the point of claim capture, Ephesoft Transact can help eradicate unnecessarily rejected or denied claims. Ephesoft Transact automatically classifies all the claim-related documentation, extracting vital information on forms such as insurance ID number, provider address, name and ICD codes and makes this raw data available for downstream processing.

Ephesoft Transact performs database lookups to validate the policy holder’s place of residence against company records and match policy numbers to names through dynamic database lookups. If the text on a claim does not match data located in the company’s system of record, the document may be flagged for further review to verify the claim is being made against the appropriate policy.

Whether the claims are submitted via paper or electronically, the ability to rapidly verify the information, identifying errors, minimizes the delay and expense associated with re-submitting claims later in the process with the correct information.

Furthermore, the removal of previously manually performed tasks, such as keyed data entry and document separation, ensures that this critical step is performed accurately, rapidly and cost-effectively.

Expediting Processing Across the Board

No matter the sub-industry, claim type, submission process or size of insurer, Ephesoft Transact provides insurance companies with the tools to decrease claim processing time, increase customer satisfaction, and improved information accuracy through intelligent content capture.

Contact us for a live demonstration or to learn more about how Ephesoft can positively impact your organization.

Click here to read case studies on how these insurance customers benefited from Ephesoft:

Washington State Health Care Authority

Baldwin & Lyons

Centers Medicare & Medicaid Services

RC McLean


Enabling Smart Capture in a Microsoft World

Discover the synergy of Ephesoft Transact and Microsoft enterprise applications

Microsoft product offerings are so pervasive, it would be difficult to find an organization not using some component of their enterprise suite. Companies of all sizes and industries manage content, maintain documents and work through business processes in Microsoft applications. Let’s look at the benefits of using supervised machine learning capture technology with Microsoft products, Ephesoft’s OpenAPI library for integration with the Microsoft enterprise suite and third-party applications, and demonstrate a content capture, processing and routing workflow.

If you work in an office, odds are, you’re interacting with Microsoft at some point in your day. Think about some of the applications in their product suite – Dynamics as a Customer Relationship Management or CRM tool, Azure for cloud storage and infrastructure, SharePoint for document and records management, Flow for business process management and basic workflow automation and Outlook for email communication. All of these applications or services have content processes in common: usage, storage, maintenance and process control of organizational content. Examples are office documents and records, application forms, customer email correspondence, vendor orders, sales contracts and internal memos.

According to a recent study, 57% of Fortune 500 companies utilize Azure and 80% of those same companies employ SharePoint for content management and storage. And nearly 50,000 organizations use Outlook for email correspondence. So how can a smart capture tool touch all parts of this ubiquitous office work platform while supporting the common organizational goals of automation and workplace digitization?

If we can assume that the core of any business is its documents and the data those documents represent, then the Ephesoft’s Smart Capture® platform gives you access to the unstructured content that lies within them. Our supervised machine learning and analytics engine can help classify documents and extract data, minimizing manual data entry and giving you structured data from unstructured content. Whether you’re scanning sales contracts into your client repository in SharePoint or using classification Web Services in Flow, Ephesoft can address nearly any document automation need.

6 Steps in Processing Document Content

Ephesoft Smart Capture aims to reduce processing time, increase efficiency, and eliminate errors in document-centric processes. Digging into the actual technology behind Ephesoft Transact, let’s break down the method by which the application handles unstructured documents.

The first step in any capture workflow is the actual ingestion of the documents. In the case of Microsoft, we have out-of-the-box connectors for grabbing documents of all types from Outlook and SharePoint in batch. Document capture can be scheduled on a predetermined frequency or triggered in real-time as new document appears at the content source, such as from an end-user scanning in a file or from an email appearing in an inbox.

Next, we move on to image processing where basic image enhancements are applied to document pages and the document is rendered fully text searchable through an embedded OCR engine. Ephesoft supports a variety of text conversion tools including OmniPage, Recostar and Tessaract.

After the document has been broken down into individual pages and made fully text searchable, the Ephesoft’s Smart Capture® platform assembles the pages into single documents and categorizes the document according to full content analysis. We use unique classification algorithms that don’t require the creation of rigid document templates for highly accurate categorization.

Once the documents are sorted into their appropriate categories, Ephesoft Transact utilizes a combination of preconfigured rules-based logic and supervised machine learning to identify and extract key pieces of metadata. These pre-defined extraction methods include capture mechanisms such as key value pair extraction where the application searches for anchor values near a desired field, pattern matching utilizing regular expressions, fuzzy database lookups and tabular extraction.

Once the application has analyzed the content and completed data extraction step, the documents may be routed to a validation queue for verification or remediation of machine extracted index fields. Fields may be highlighted in a validation user interface (UI) based on the confidence value (or certainty of correct information) determined by the application. For example, if after this text analysis, the application’s output for the field invoice total falls below the designated confidences core, Ephesoft Transact’s built-in document processing workflow will trigger that document (and that specific field) to be flagged for review by an end-user.

The final step in the content processing workflow is exporting the content – represented by the sorted documents and their associated data files, stored as an XML or CSV – into their final location. In a Microsoft environment, this can involve routing a document into SharePoint online, Flow, Dynamics, or it can simply send the document to a hot folder for a downstream system to pick up and use.

Smart Capture in a Microsoft Workflow

There are two distinct stages of a document-centric workflow where a component of the Microsoft enterprise suite would interact with Ephesoft.
Upstream capture and document onboarding
Mid-flow processing

Let’s walk through an example workflow where Ephesoft acts as up-stream capture in a common document-centric process.

Example #1: Document Onboarding with Ephesoft

Let’s say a vendor sends your company an invoice. Given the user count statistic I shared a few minutes ago, it’s safe to assume that your organization uses Outlook, and the invoice is sent to an Accounts Payable inbox via email attachment.

Ephesoft Transact monitors that inbox for new, incoming messages, and automatically ingests the email and the attached document as a part of its initial capture workflow.

Then, Ephesoft Transact identifies the email attachment as an invoice through full content analysis of the document. Remember, rigid document templatization is not a factor with Ephesoft’s Smart Capture® product suite, so it doesn’t matter if all your vendors format their invoices slightly differently. We’ll be able to recognize that information regardless of the document layout. Based on the categorization of invoice, there are key data fields that need to be extracted to populate downstream systems and processes. Using a combination of rules-based capture definitions and supervised machine learning, the application identifies fields like invoice total, net payment terms, vendor name, and line item quantities.

Next, we need to make sure that the address listed for the vendor on that document is the same address we have on file in our CRM system, so we do a database lookup to Microsoft Dynamics. If the addresses do not match, the invoice can be flagged in a validation queue for end-user review. Or we can have Ephesoft push an address update call to the CRM to update that database.

Lastly, the invoice and its associated metadata is routed to SharePoint via our out-of-the-box export plugin. And all of this was accomplished completely transparent to the end-user. How many different Microsoft applications did our example touch without a document scanner, clerk, or employee having to key in a single field or manually relocate an electronic file?

If you’re one of the many thousands of companies using Azure for cloud infrastructure, all of this can be installed on the Microsoft cloud to mitigate the burden of server management for IT.

Example #2: Mid-flow Processing

Maybe you need to be able to classify or convert documents or extract metadata through code as a part of an existing workflow. Ephesoft’s OpenAPI provides a powerful document capture automation tool and OCR platform within the world of Microsoft.

Application interoperability through Web Services

Understanding Swagger or OpenAPI Specifications will give us a better base to explain our example.

Swagger, also referred to as OpenAPI Specification or OAS, defines a standard, language-agnostic interface to RESTful APIs. For the non-technical folks in this webinar, it is essentially the definition and description of an API, and this allows people – as well as robotics processes – to discover and understand the capabilities of that Web Service without needing to access the source code or product documentation. When a Web Service call is properly defined within Swagger, a consumer can understand and interact with the remote service with a minimal amount of implementation logic.

3 Benefits of OpenAPIs

Minimize IT burden
Enable plug-and-play capture workflow
Better support application interoperability

To start, this is a tremendous benefit for the IT and service teams working on implementing a project. It greatly minimizes the amount of custom coding or scripting any given multi-application solution requires. Moreover, this easy-to-use Web Service call enables true plug-and-play functionality with Ephesoft as a capture mechanism within a document processing workflow. In sum, it expands support for application interoperability, and with so many different systems and applications used in a Microsoft environment, the Ephesoft Swagger is highly valuable.

Mid-process capture with Ephesoft

In this use case, let’s imagine we’re working with an insurance company. Similar to the previous example, we’re going to start this process with an email received in Outlook and end the process with documents in SharePoint.

A client emails an insurance form or claim submission to their agent. The insurance company uses a Robotics Process Automation, or RPA, system to monitor incoming emails. The system grabs the email from the client along with the attached form and sends it to Ephesoft Transact for processing.

Ephesoft identifies the form and document types from the email and attachments, and based on that identification, automatically extracts key pieces of data such as name, claim number, dates, and so on. In this case, Ephesoft performs a signature check on the forms to make sure the claimant has filled out all necessary signature fields. Once Transact completes its capture workflow routine, the documents along with an XML file of the extracted data is picked back up by the RPA system.

The RPA tool then reviews the data that the Ephesoft platform extracted and makes a determination whether this document can be sent to SharePoint to be added to the client’s file, or if there is missing information like a signature or key fields were left blank, the system can send an email back to the claimant to let them know additional information is needed.

In this instance, Ephesoft Transact enters the document progression mid-way through the workflow, but is still providing a crucial element of capture automation to enable this touchless insurance claim process.

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5 Benefits of Intelligent Process Automation

Intelligent Process Automation, commonly referred to as IPA, is the ultimate step of a digital transformation for organizational information and content management. At its core, IPA is a combination of robotic process automation (RPA) and machine learning techniques, integrated with the organization’s line of business applications and back-end systems.

Let’s review the most impactful benefits of implementing a comprehensive IPA solution: operational process automation, reduction in information processing errors, time and operational costs, increase in compliance and an improved customer experience.

Automation

The most obvious benefit of IPA is in the technological trend’s name – automation. The word automation can mean something different for each person, process, line of business and organization, although it can simply be thought of as a process improvement using technology. For the mailroom clerk, automation may be the pre-defined sorting and forwarding of incoming correspondence. For the sales manager, automation is the routine approval of travel expenses that fall below a specific monetary threshold. For the records manager, automation is a touchless experience when company documents that reach the end of their retainment lifecycle.

Ephesoft’s Smart Capture® platform aids in process automation by eliminating manual intervention in document-centric workflows. Through a combination of supervised machine learning and rules-based logic, Ephesoft Transact automates the capture, conversion, sorting, indexing and routing of organizational content. In the case of the mailroom clerk, for example, this could mean the ingestion of incoming electronic faxes, classification of different document types – such as invoices, purchase orders or sales contracts – extraction of metadata and file export into a RPA, line of business or back-end document management system.

Reduction in processing errors

Removing the human element of basic office processes minimizes the chance of making manual errors, such as keying in a piece of data incorrectly, accidentally sending a document to the wrong person or associating a record with the wrong customer or vendor file in an ERP or CRM application.

Ephesoft Smart Capture® helps decrease processing errors by removing many of the time-consuming, manual actions performed during document capture and record identification workflows. One of the most common causes of record “misfiling” is human error when naming a file or selecting values from a drop-down list. Ephesoft Transact’s open architecture and pre-defined capture logic allow the application to query third-party databases like a vendor account database in an organization’s ERP system to verify information. Data “lookups” for company addresses, point of contact details and payment terms can be a key step in the Ephesoft capture workflow when processing new documents. This automatic validation ensures that incoming documents match the on-record data on file and reduces the risk of a new document being associated with a mistaken file.

Decrease in processing time and operational costs

Automation implies improved productivity and efficiency gains, which is at the core of IPA. Machine learning – both supervised and artificial intelligence – power robotic technology that enables automation. Therefore, it should come as no surprise that eliminating manual tasks and human intervention speeds up processes.

With Ephesoft Transact, document capture processing time is typically reduced by 67% and labor costs decrease by between 30% to 50%. Where a human employee might spend several minutes reviewing and indexing a single document, the same actions could be completed through robotic computation in microseconds. When more content is processed with less data entry, a greater volume of work can be completed. This translates to significantly lower operational costs and shorter workflow cycles.

Increased compliance

Intelligent process automation can ensure data privacy, records retention, sales policies and financial regulation requirements are upheld. Legal compliance for organizational policies spans all industries, and the systems and practices in place to uphold these policies are often highly manual. However, once a process has been established using IPA tools, that process or workflow can be executed repeatedly without error or deviation.

For example, consider GDPR requirements for PII protection. GDPR mandates customer records containing personal and private information must by digitally secured through encryption and identified as linked records. With Ephesoft Transact embedded into an organization’s content ingestion and management process, documents could be automatically flagged if Ephesoft’s Smart Capture® tools detected sensitive customer data through full-text analysis and pattern matching.

Improved customer experience and satisfaction

An often-overlooked soft cost of process automation is the overall improvement of the customer’s experience. Consider the mortgage industry, for example. A couple applies for a mortgage loan for the purchase of a new home. They fill out the stacks upon stacks of application paperwork required for a new loan and submit their information to the mortgage lender or bank. Without an automation tool, the mortgage company would have to manually sort through the files – electronically or even in physical paper form – verify applicant data, key-in submitted data points to backend applications, and then double check work performed in case of mistyping errors or overlooked application details.

With Ephesoft Transact to process the incoming application files, all this laborious, menial labor can be automated. Minimizing document processing time by eliminating the human element of document sorting, data entry, and information validation decrease the amount of time loan documents spend in the underwriting stage. When a smart document capture platform is combined with an RPA system, document processing becomes even more intelligent, and thereby a true IPA solution. The faster loan approval results in improved customer satisfaction, loyalty and an overall better experience.

In summary, organizations and government agencies that make the most of available technology to support IPA will have a clear advantage over organizations that stick with their manual processes. Contact us or schedule a demo to learn more about how your business can generate efficiencies, decrease operational costs, and improve customer satisfaction through document processing automation tools.

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