Aetna Inc. (Aetna) is a US-based health insurance company, which offers health insurance plans and services, including medical, pharmaceutical and dental plans, Medicare plans, Medicaid services, Behavioral health programs, and Medical management.

Opportunity

The client had around 70,000 records in the backlog, which they needed to process. Due to all the manual work, the cycle time of servicing/processing the request and performing quality checks was quite high. Owing to the complexity of the process and rules, users were not able to go through all the possible rules, resulting in human errors.

Due to the spike in backlog volume and some percentage of human error, the cycle time for servicing/processing requests was impacted, and records were not getting processed properly. It led to reduced client satisfaction. It was also challenging for the operations team to scale and train the new resources while processing all the backlog volumes without any error.

Solution

With AssistEdge RPA, the client could automate repetitive and rules-based business tasks. The software bots check and verify multiple rules and can easily scale as per business needs.

Outcome

25 main rules logic processed with each main rule consisting of 5 sub-rules
10,000 transactions processed
Backlog volume reduced drastically

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