Becoming a Digital Business

Moving from Manual to Digital

After a systematic diagnostic review of its existing process, the organization identified two main bottlenecks in its health microinsurance claims processes: claims processing from hospitals where Britam health microinsurance customers were served and data entry from physical documents into the IT system.

Hospital claims processing has been a significant pain point for many years. The existing process caused lengthy delays and dissatisfaction among partner hospitals, some of which threatened to leave the network. As Britam serves underserved customers in remote and rural areas of Kenya, the delays due to paper based processes were exacerbated.

Partner hospitals had to manually check whether a patient was covered by Britam MI’s insurance in a spreadsheet, before emailing a pre-validation form to the company. Then, after treating the insured patient, the hospital would have to send in all the physical paperwork. This information was then manually entered into Britam MI’s IT system, causing considerable delay, taking anywhere from 60 to 70 days from the time the customer was discharged.

Furthermore, the business unit’s helpline was constantly flooded with queries from hospitals and clients, half of which related to claims payments and pre-authorizations for inpatient claims

An Enhanced Partner Portal

At the time, Britam was undergoing a digital transformation project with Liferay and their success prompted Britam MI to explore how Liferay could solve their unique business challenges.

Using Liferay DXP, InfoAxon Technologies was able to build Britam Microinsurance Digital Servicing Platform, an easy-to-use partner portal designed to improve the old processes and address operational issues that were hindering Britam MI’s ability to rapidly scale in a cost-efficient manner.

The first challenge the portal addresses is identification. The simplicity of the portal allows partner hospitals to easily check a member’s validity and submit all claims information and documentation digitally.

The Digital Servicing Platform also simplifies the approval process, enabling partner hospitals to directly put in their requests online and minimize their wait time.

Furthermore, the platform has reduced significantly the duration it takes from servicing clients to the time claims payment are made to hospitals by 80%. Additional cost efficiencies from the portal solution also include gradual savings in redirecting data entry staff to other tasks and decreased expenses on printing, transfer, scanning, and storage of paper-based claim documents. Britam MI predicts savings in excess of $100,000 over the next four to five years.

Lastly, Britam used the partner portal to help tackle the challenge with claims processing. They’ve started to roll out the portal to 60 hospitals and already have begun to see considerable improvement and savings within a couple of months. Claims turnaround has dramatically reduced to less than 10 days from what originally took upwards of 70 days.

Esther Akoth, Head of Insurance Claims at a partner hospital said, “the systems have really helped improve our processes and efficiency, which has led to better working relationships with Britam and patients to deliver customer satisfaction.”

Some partner hospitals, satisfied with the speed and simplicity of the portal solution, are now offering up to 5% “prompt claim payment discount” on claims cost, representing a considerable saving for Britam.