Skip to Content
HSCS Client Story

Document Automation Tool Improves Accuracy for Health Insurance Company

Client: Largest US-based, mutual reserve health insurance company
Region: North America
Sector: Insurance

Capgemini collaborated with the healthcare company to identify a new tool that led to a streamlined, frictionless production process and reduced errors.

success story ChallengeClient Challenge
The health insurance company wanted to accurately and efficiently produce benefit booklets that outline member insurance packages and meet the aspirational goal of sending them out in under 60 days.
success story SolutionSolution
Capgemini collaborated with the healthcare company to identify a new tool that led to a streamlined, frictionless production process and reduced errors.
success story BenefitsBenefits
Faster, more frictionless benefit booklet production and release
Reliable error categorization and identification
Faster training for new employees

Innovation for aspirational purposes

When it comes to health insurance, accurate and timely benefit information is of absolute importance to customers. Any discrepancy or delay to the delivery process may hinder the use of benefits or result in difficult health-related decisions. Understanding this, one of the largest US-based, mutual reserve health insurance companies identified a need to improve the speed and accuracy with which it produced and distributed benefit booklets.

However, identifying the challenge and resolving it were two different things. The company knew that it needed a partner to help accomplish the success it envisioned. Starting in 2015, the organization expanded its existing relationship with Capgemini, who already engaged with the company on application development and management. In the years that followed, the partners delivered the benefit booklets faster, but remained short of the aspirational goal of sending them out to its customers in under 60 days.

New tools meet new ambitions

In 2020, Capgemini was determined to fulfil the company’s 60-day ambition. To do so, the project team performed extensive research to identify new technologies and opportunities for process enhancement that would deliver the necessary efficiency gains. Following this review, Capgemini understood that there were two primary areas in which booklet production could be improved: streamlining processes and procedures through automation, and standardizing language updates wherever possible.

Each year, the health insurance company updated the language used in its benefit booklets to keep up with regulations and changes to the products it offered. This previously required every change to be manually completed by members of the project team. To improve the speed with which this could be done, Capgemini introduced a new, macro-based Magic Wand tool that automatically copies the updated text into the booklet format. This substantially reduced the manual, repetitive tasks that required employees’ time and attention, while also cutting down on human error, leading to a more frictionless production process.

To further improve the accuracy of the language in the booklets, Capgemini identified a second macro-based tool that identifies errors in the wording and highlights them for correction. The tool uses previous errors to learn rules that it rapidly applies tot he new wave of booklets, improving the team’s ability to identify pre-categorized issues. This involved new requirements added that year, which represented the largest source of errors. In this way, the
inspection tool not only improved the accuracy of the booklets, but also helped to communicate challenges and make company stakeholders aware of process breakdowns that could be corrected.

Lastly, Capgemini introduced a new training tool that substantially improved the pace at which new employees were onboarded. Originally, it took six months to fully prepare a new team member for booklet production. With the new tool, this was reduced to a single month – ensuring that the team was properly prepared for intense, high-volume periods resulting from annual open enrollment.

Innovation delivers critical information to customers

With the new tools for processing benefit booklets and improving training methods, the partners achieved their 60-day delivery goal, producing higher-quality, more accurate booklets – without requiring experienced employees to perform lengthy and repetitive work. This new frictionless process ensures that health insurance members have access to essential information quickly and more reliably, and can be replicated annually.

Following this success, the partners plan to continue streamlining the production and quality control processes. By identifying opportunities for improvement from both sides, the partnership will ensure that neither the health insurance company nor its members will experience anything other than exemplary quality benefit information.

Contact Business Services

To learn more, contact Capgemini’s Business Services at: businessservices.global@capgemini.com

To stay up to date with our latest thought leadership pieces, product launches, and news – click here

Innovation Nation | Summer 2022 edition

Innovation Nation is much more than a magazine – it’s a zoom on what’s been happening in the last six months across the world of Intelligent Business Operations.