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Back Industry: Healthcare

Fielding a spike in insurance claims

COVID-19 Challenge

Handle high call volumes more efficiently and quickly.

Today, about 90% of insurance companies do not have the ability to adjudicate the COVID-19 claims.

Therefore, when a patient arrives for a COVID-19 test or treatment, about 90% of their claims are denied, and the patient is forced to pay for any blood test upfront—usually around $2,000.

This problem ends up hitting insurance companies’ contact centers which are dealing with a high volume of calls.

Solution

A publicly funded healthcare system in Europe is building an audit robot to survey claims data. This should help people to get a more immediate and clear view of their eligibility to access insurance money for their blood test.