The Royal Children’s Hospital partners with Protiviti to enhance its private health insurance claim process

The Royal Children’s Hospital partners with Protiviti to enhance its private health insurance claim process

The Royal Children’s Hospital partners with Protiviti to enhance its private health insurance claim process

 

With Australia’s health expenditure growing at a rate of A$181 billion annually and being 10.3% of the Gross Domestic Product (GDP),[1] public health services are increasingly reliant on an efficient private health insurance claims process. Effective claim processing benefits businesses by improving cashflow, reducing operational costs, and improving customer satisfaction through better service quality. Due to traditional, and more manual, processing methods, claim processing cycles tend to be tedious and provide many opportunities for errors to occur. Further to this and due to the process being highly manual and repetitive, it is not an enjoyable activity for people to do. In such a scenario, implementing Robotic Process Automation (RPA) can help significantly reduce claim processing time, lower operational cost and improve the accuracy of each claim.
 
The Royal Children’s Hospital (RCH) is an Australia based specialist Paediatric Hospital that has been improving the health and wellbeing of children and their families for 150 years through leadership in healthcare, research and education. The RCH provides health offerings in over 26 specific lines of care from allergy and immunology to urology as well as broader services to the public including tertiary care, health promotion, prevention programs, paediatric rehabilitation, palliative care, forensic paediatric medical, and infant hearing screening services.
 

The private health insurance claim process at the RCH has historically been a very manual and time consuming activity with staff processing an average of 1,500 invoices monthly.

In order to improve cashflow and the efficiency of the claims process, the RCH engaged Protiviti to develop and implement an automated solution for the health insurance funds claims process.

With the help of Protiviti’s methodological approach, the RCH completed this project with several advantages. First, their existing ways of claims processing was automated to provide long term operational efficiencies and cost savings by automating a total of 265 business rules which led the RCH to save 115+ manual hours per month. There was also a considerable reduction of rejected claims (9%). Secondly, implementation of the bot reduced processing time from 5 minutes to 1 minute all whilst being available 24*7 and maintaining a robust and error-free process.

Recommendations

As demonstrated by this health service, RPA can be deployed to drive innovation, boost operational efficiency and enable staff to focus on more complex activities. In this scenario, it was claims processing that proved to be a suitable candidate for automation due to its manual, and repetitive nature.

The key to success is to follow a deliberate and disciplined approach with an innovative mindset and the right partner.

Contact one of our RPA leaders below to learn how automation can benefit your business.


[1] With Australia’s health expenditure is growing at A$181 billion and 10.3 per cent of their Gross Domestic Product. Source: The University of Melbourne.

 

Contacts

+61.437.601.774
+61.431.285.494
+61.469.637.913

 

Lauren Brown
Lauren Brown
Managing Director
+61.437.601.774
Linked
Ghislaine Entwisle
Ghislaine Entwisle
Director
+61.431.285.494
Linked