Finding an Upgrade on the Existing Claim Management Reality

Human beings have always enjoyed the means to do plenty and then some, but despite that being the case, there remains little that we seem to do better than growing on a consistent basis. This progressive approach, on our part, has already got the world to hit upon some huge milestones, with technology appearing as a major member of the stated group. The reason why technology enjoys such an esteemed stature is, by and large, predicated upon its skill-set, which guided us towards a reality that nobody could have ever imagined otherwise. Nevertheless, if we look up close for a second, it will become clear how the whole runner was also very much inspired from the way we applied those skills across a real world environment. The latter component was, in fact, what gave the creation a spectrum-wide presence, and consequentially, kickstarted a full-blown tech revolution. Of course, this revolution then went on to scale up the human experience through some outright unique avenues, but even after achieving such a monumental feat, technology will somehow continue to produce the right goods. The same has grown increasingly evident in recent times, and assuming one new insurtech-themed development shakes out like we envision, it will only make that trend bigger and better moving forward.

Appian, a software company that automates business processes, has officially confirmed Global Excel Management’s decision to select its Appian Connected Claims Solution for the purpose of enhancing the traditional insurance claims processes. Already a leading provider of risk mitigation, cost containment, claims management, and medical assistance services, Global Excel Management can now leverage Appian’s proprietary platform to modernize operations and optimize claims processes using the solution’s data integration, AI, and process automation capabilities. The idea here is to expedite claim settlements, reduce costs, and enhance the customer experience. Furthermore, the technology in question should also come in handy when the agenda is especially to configure workflows without IT intervention, and therefore, allow new institutions and policies to enjoy a swift onboarding process. Markedly enough, this decision to formally trust Appian follows up on Global Excel Management’s recent success with implementing a claims portal and a First Notice of Loss (FNOL) intake process in less than 12 weeks, something it achieved using Appian adaptable workflows. Moving forward, though, the company plans to enhance adjudication of the entire claim process. Talk about some granular level benefits that Appian Connected Claims solution will likely bring to the table, we begin from well-connected data and systems. You see, by connecting every relevant outlet, the platform will essentially unlock a 360-degree view, a view which is going to extend the value of claims software such as Guidewire, Amazon Connect, and Salesforce etc. Next up, we have the prospect of accelerated time to settlement. Leveraging automated claims processing technology, the platform will be able to cut back significantly on the time that we have come to associate with such procedures, and as that happens, the mechanism can also be expected to improve data quality, reduce claims leakage, and increase straight-through processing. Not just operational efficiency, though, Appian Connected Claims Solution has further dedicated a serious amount of focus towards user security. This fact reveals itself once you consider the way solution can enhance your fraud detection capabilities by preventing payouts on suspicious claims or initiating Special Investigation Unit (SIU) referrals for further investigation.

“As a worldwide expert providing a comprehensive range of healthcare risk management solutions, we needed a partner who could help us navigate the technological intricacies of our industry with heightened efficiency, while maintaining a commitment to operational excellence and client-centric service,” said, Kelly Maurice, VP of Digital Solutions at Global Excel Management. “With Connected Claims our goal is to unify and extend data, optimize our first notice of loss and claims intake, and accelerate the entire claims process.”

But what makes Appian an ideal partner for such an effort? Well, the answer resides in its industry-leading ability to automate business processes and make them more effective. The company delivers on this value proposition through a solution line-up, which presently covers areas like Low-Code Application Development, Business Process Management (BPM), Application Platform-as-a-Service, Dynamic Case Management, Social Business Collaboration, Enterprise Integration, Intelligent Automation, low-code enterprise software, and cloud platform etc. Appian’s excellence in providing these services can also be understood once you consider it has already played the role of a trusted partner for brands like Accenture, Amazon Web Services, Alventus, Capgemini, Cognizant, Deloitte, DocuSign, KPMG, Microsoft, Persistent, PWC, and many others.

Making the whole development even more valuable is, of course, Global Excel Management’s own stature. Founded in 1996, the company’s rise stems from its assortment of global healthcare risk management solutions that are concerned with disciplines like cost containment, claims management and medical assistance. The credentials of these solutions are only solidified by the fact that they serve, at the moment, well over 360 clients in 90 different countries across the globe. Apart from it, we must also mention how Global Excel has processed over 719k bills till date, amounting to an estimated $1.9 billion in worth. The company has also managed 360k+ inpatient, outpatient, and non-medical claims; all while handling more than 2.7 million calls.

“The era of prolonged, cost-prohibitive modernization projects is behind us,” said Sanat Joshi, Executive Vice President of Product and Innovations at Appian. “Insurance companies need technology that helps them adapt and evolve quickly. Appian’s integration of people, automation, AI, and data in unified workflows, delivered at low-code speed, means insurers can imbue transparency and efficiency into their claims environment. We are excited to support GEM on their transformation journey.”