How a Fortune 500 Payer Reduced Turnaround Time without Minimizing Quality Using AI

Case Study 18 | Medical Claims Program

Introduction

A major U.S. Health Insurer processing thousands of medical claims per month, from a globally distributed workforce, wanted to reduce turn-around time and manage costs, whilst adhering to a 99.5% regulated quality requirement.

Benefits:

  • Up to 10x reduction in claim processing time compared to traditional “full human” translation
  • Up to 3.5x reduction in claim processing time compared to hybrid claims processing.
  • Proven and reported 30% reduction in total cost for average claims processing
  • No impact to regulatory quality demand

Chapter 1

THE CHALLENGE

Market Challenges

  • Highly regulated quality requirement 
  • Thousands of individual projects monthly from a globally distributed workforce 
  • Significant enterprise time and cost pressure for a non-revenue generating cost center

"Being able to see the positive KPI's with a consistent volume of 9000 files and a deliverytime in under 48 hours is unheard of. All payers should consider this technology"

- Sean Roadhouse, Sr. Project Manager at United Language Group

Chapter 2

THE SOLUTION

United Language Group (ULG) provides the largest combined set of language-based solutions in the world. For this solution, we combined Artificial Intelligence (AI), Language Identification (LI), Optical Character Recognition (OCR), Translation Memories (TM), curated Machine Translation (NMT), workflow optimization and automation, integration technologies, as well as a dedicated team of linguistic and project management professionals with deep domain experience.

In combining this unique set of resources and skills, ULG was able to deliver something truly unique: an entirely new claims translation platform that radically altered the time and cost basis of delivery without any impact to the exceptionally high-quality threshold.

Contact ULG today to discuss where technology can be used to accelerate your enterprise opportunity.

ULG Deliverables

  • Custom Medical Claims Platform 
  • Integration of AI, LI, OCR, NMT and TM
  • Automated workflow and approval processes tailored to client 
  • Curated NMT targeted to specific content application
  • API integration to existing customer platforms for seamless workflow 
  • Dedicated and specialized training program
  • Global solution launch and deployment support

Chapter 3

PROVEN RESULTS

  • 3x reduction in average claim translation process cost
  • 3.5x – 10x reduction in claim translation turn around
  • Delivered 100% on time translations
  • Exceeded quality score KPIs 
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