Automating the Process of Sending Inquiries in Private Health Insurance by Using API Management

Overview & Challenge

One of our clients, working in the insurance industry, a broker deals with selling private health insurance to companies of different industries. During the entire years of existence, the company has built a very high reputation of itself thanks to the services it offers, custom-made insurance packages, prompt information, delivery, and the relationships it builds with its customers.

To support the next step of growth and to improve the services it offers, the client decided to automate the process of submitting inquiries, based on the previously chosen package, and to decrease the errors that appeared as a result of the previous process of using a template.

The process that the client had until the moment they decided to turn to automation included providing a wide variety of private health insurance packages to companies of different sizes and industries. Once our client’s customers decided on the packages, they were given templates for submitting inquiries. The number of inquiries per month was huge and different for each customer. Although there were instructions on how to fill the inquiries and all needed documentation, the chances for human-based errors and lack of information were huge. Moreover, there was a lack of connection between the public and private health insurance, and very often one injury would have been covered by both public and private insurance – if not properly checked.

Solution

The client was aware that they should automate the entire process and find a way to connect the public and private health insurance, and also get information about the insurance companies that the employees of the customer are using. Our Microsoft team proposed using APIs to create a web solution that will get the requests from the employees of the client’s customers. The solution is implemented in the customer’s system, so the time needed to enter the employees’ data separately is eliminated. The solution guarantees data security, as the broker defines the IPs that will be able to access the APIs with confidential information.

Business Outcomes

The solution enabled the client to connect the public and private health insurance, automate the process of sending and receiving inquiries. This, in turn, decreased the time needed to process the inquiries and eliminated the chances for mistakes.

  • Decreased the paperwork by 70%
  • Reduced time spent on creating and submitting the inquires for the clients by 60%
  • Uniform inquires data format
  • Reduced time spent in communication between the inquiry requestors and the broker by 80%
  • Reduced time spent in communication between the broker and the insurance companies by 30%
  • Reduced time spent in communication between the insurance companies and the healthcare organizations by 10%