Overview

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 member sends a form authorizing Aetna to share his/her information with a third-party (person/organization). The analyst reviews the form and updates systems with the third-party authorization for member policy. The analyst then sends a letter to the member indicating the third-party authorization is updated for all the policies he/she holds.

A manual process, each update takes approximately 12-15 mins.

Solution

With AssistEdge RPA software, Aetna incorporated the logic of pre-defined conditions in RPA bots to process every third-party authorization request. The bots run throughout all days, including weekends, with very little downtime.

Outcome

Delivered 50% reduction in AHT (from 15 mins to 7 mins)

Enabled effort saving equivalent to 5 FTEs

Can deliver a potential savings of $500K savings over the next five years

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