Claims Appeal Handling

Improve the process of reviewing policy complaints and appeals by automating the manual work, increasing data accuracy and reducing handling time.

Why it is important

When members submit policy complaints and appeals, it takes several teams to review the cases. Any slowdown in the appeal process can cost significant time and money.

What needs to be improved

Appeals are requested via email, fax, phone, or web form. Member and complaint information must be manually entered to start the appeal process, which must then be routed to the next appropriate handler.

How Alindus can help

Our Robotic Workforce provides a more efficient solution for claims appeal handling. Our solution:

Capabilities

Extracts data using OCR and machine learning models to classify and automatically route requests into queues.

Provides increased accuracy with an exception-handling workflow that flags anything that is unable to be processed.

Improves the customer experience by automating classification, saving time and money, and preventing misdirection and reducing human error.

Businesses that leverage 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%.

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