In January 2023, we partnered with AdvanceCare, a leading healthcare insurance group. This strategic collaboration is transforming their claims processing, streamlining operations, and elevating the overall customer experience.
AdvanceCare can scale its business by serving more customers, while maintaining an exceptional claims experience.
Key results
- Claims settlement turnaround time reduced to near real time – some routine claims being settled in just 60 seconds.
- Exceptionally high accuracy levels achieved in processing invoices across multiple categories.
- Increased work capacity and reduced work volume per team member through AI technology.
- Potential for AdvanceCare to scale its business by serving more customers while maintaining exceptional claims experiences.
- Claims handlers freed from low-value, repetitive tasks to focus on higher-value responsibilities, optimising the customer experience.
- Successful integration of AI technology to improve digitalisation and efficiency efforts.
- Improved customer satisfaction and loyalty through quicker and more efficient claims management.
Background
AdvanceCare had already made major strides in its growth and customer service capabilities since its integration with the Generali Group in 2020. However, to further scale their operations while maintaining exceptional claims experiences, they needed innovative solutions. That’s where we came in. Our advanced AI technology could help AdvanceCare to unlock complete end-to-end claims automation.
The pilot phase
Before formalising our partnership, AdvanceCare conducted a rigorous pilot phase with us. This involved scrutinising our technology’s processing of a diverse sample of healthcare invoices across various categories, including hospital, dental, pharmaceutical, independent workers, and optical. The results were 98% accurate across all categories. This pilot provided AdvanceCare with the confidence and data necessary to proceed with the integration of our technology.
How sprout.ai works
- Claims data is extracted and validated across documents for accuracy and correctness.
- All of the key information necessary to process a claim is identified.
- Missing information is automatically flagged and coverage is verified.
- Claims descriptions are mapped to categories or codes and confidence levels are provided.
- A full claims view provides centralised claims data and findings.
Benefits
Sprout.ai’s AI technology offers many advantages for AdvanceCare.
Efficiency
One of the key benefits is increased work capacity and a reduction in work volume per team member. This empowers AdvanceCare to scale its business and serve a larger customer base without compromising on the quality of claims processing. Claims handlers can reallocate their time away from low-value, repetitive tasks towards more valuable and rewarding responsibilities, ultimately optimising the customer experience.
“AdvanceCare is continuously seeking innovative ways to enhance the insurance claims experience. We selected Sprout.ai as our partner because they have demonstrated that their technology and approach can propel us one step further in our digitalization and efficiency journey.”
Sergio Melro, Chief Operating Officer at AdvanceCare
Customer satisfaction
AdvanceCare now has access to complete end-to-end claims automation, allowing for more efficient claims handling and quicker turnaround times. This is resulting in improved customer satisfaction and loyalty.
Using AI in the indexing process will enable the AdvanceCare team to manage claims more swiftly and efficiently, enhancing the customer experience. It’s a win-win for everyone, and we are delighted to be part of this positive change.
Sprout.ai CEO Roi Amir