With digital customer interactions delivering information across a range of channels, Digital TPAs eliminate paper through automating document, payment and e-statement processing, leveraging artificial intelligence (AI) to route transactions to specialized teams, resulting in improved data collection and better insights.
Paper—incoming, outgoing and everything in between
In the cost savings measures of the late 1990s, reduction of paper was often a target. Heavy front-end investments ploughed into software and hardware enabled documents to be moved through a process step by step.
Digital TPAs see paper reduction in a different light, turning data formerly on paper into digital elements that can be accessed, sorted, trended and evaluated. This provides new ways to improve productivity, savings and service across the three main interaction streams—incoming, outgoing and intra-operational.
Although service organizations have been scanning and processing digital images of paper documents for over 25 years, Digital TPAs do away with paper by deploying inbound electronic feeds (EDI), payment portals for processing premium payments (EFT, debit, credit and mobile/app) and online status inquiry solutions (portals, chat, email).
In situations where Digital TPAs do receive paper, they leverage intelligent character recognition (ICR) systems to recognize common forms, capture the needed elements in digital format and route them using AI for processing, or complete the request via automation. Digitizing these interactions across the service model delivers outcomes that include cost reduction, enhanced efficiency and improved customer experience.
What comes in mustn’t go out
TPAs depend on effective communication to be successful. To this end, Digital TPAs leverage interactive voice recognition (IVR), status portals, email, chat and text messages to communicate with policyholders, providers and other interested parties. This creates significant opportunities in how Digital TPAs respond to or initiate certain activities.
For example, billing statements, an explanation of benefits and other correspondence are efficiently and effectively handled through the method of choice, with advances in electronic payments bringing new options to the table in the form of virtual cards. Digital TPAs only see 15% of provider payments made through traditional paper check and mail methods.
One of the most difficult transitions in a digital journey is the removal of paper used inside an organization. Digital TPAs deploy a complete ecosystem of solutions that remove dependency on email and paper from internal processes to provide the end service to the customer. Although turning off printers and internal email can be quite challenging, it is often the most effective method of encouraging staff to use the deployed tools as intended. The payoff is the consistent source of truth for data and a complete view of the data points represented inside a particular process.
In summary, digitizing at all phases of the service lifecycle delivers more than just paper reduction. The digital journey towards understanding and serving customers’ needs centers around capturing elements previously locked up in the pages of static document images and creating new ways to interact in the digital domain.
The increase in digital data capture enables Digital TPAs to leverage analytics and robotic process automation (RPA) in ways not possible outside a fully digitized model. As a result, Digital TPAs are set to have a positive impact and yield significant savings and service improvement benefits for insurers in the future.