Case Study

HGS Employs Automation to Drive Significant Savings for Major Payer

Digital Transformation

Since 2003, a U.S.-based, top-five healthcare payer actively working to balance member cost per month with better member outcomes, has turned to HGS for BPO savings and improvements.

To deliver continuous value to this treasured client, HGS recently introduced robotic process automation (RPA), and major changes are underway within some of this client’s central lines of business. This solution employs screen scraping, workflow management, task automation, data extraction, clipboard, and keyboard shortcuts. HGS suggested several RPA methods for reducing the overall call-handling time for provider customer care (PCC) queries.

HGS provided dedicated RPA resources to lead the project. The RPA team scoped out a phased approach over a six-month period. The RPA team obtained security clearances and installed a third-party real-time (RT) designer tool to drive the automation project. Once installed and configured, HGS used the RT designer to simplify and automate the steps to resolve provider issues.

  • We saved the client $700,000 per year via average handle time reduction.
  • According to three different scenarios, 20 and 80 seconds were saved per call amounting to 8% to 17% average handle time savings with automation.
  • Per those three scenarios, HGS automation solution may save 42 to 82 seconds (or 13% to 15% time decrease), depending on the scenario.
  • HGS has recorded quality improvements up to 99.01% from the original 98.19%.
  • Agent retention is improving overall with 5% improvement since inception.