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 AdministrationDeployed 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