How AXA Global Business Services Transformed the Doctor Care Anywhere Process

In the world of insurance, handling cases manually can be a tedious process. Not necessarily slow, but definitely tedious.

At AXA Global Business Services, the Health Claims Pre-Authorization Team, working closely with AXA Health UK, manages a high volume of cases in the Doctor Care Anywhere (DCA) process. The DCA process connects AXA Health insurance policy members located in the United Kingdom with virtual General Practitioners (GPs). Instead of visiting a clinic, members can connect with a doctor via phone or chat, receiving advice, prescriptions, or referrals without leaving their home – and much faster. This service is especially valuable when waiting times at clinics are long or when quick advice is needed.

Each DCA case involves multiple steps and applications. Typically, the process requires using at least seven different applications to check policy details, verify data, analyze requirements, and fill out multiple forms before requesting rejection or approval. The team had to toggle between these applications, manually input data, and ensure everything matched, which was time-consuming – taking around 18 minutes per case!

Automating With a Purpose

This is when the Health Claims Pre Authorization Team and the Industrial Automation Team at AXA GBS collaborated with a clear purpose – to make this process faster, more accurate, and less burdensome – for not just AXA entities, but to protect the time of the customers at the end of the line

Subject Matter Experts (SME) from the Health Claims Pre Authorization Team and Business Analysts, Developers, and Project Managers from the Industrial Automation Team thoroughly assessed the entire process, discussed pain points, and analyzed each step involved – click by click, application by application.

One of the biggest challenges was overcoming the system silos – many of the involved applications didn’t communicate with each other, and the data was scattered across different systems. Despite this, the teams developed automation solutions that could verify details such as member identity and policy coverage, fill out forms automatically, and help determine whether a case was within the scope of a GP or needed a specialist referral.

The “3 Technology” Approach

The automated process was designed around a “3 technology” approach, aiming to eliminate maximum redundant effort from the human side – especially the most manual and repetitive steps where human potential is often wasted. The three pillars of this approach are:

·      Robotic Process Automation (RPA): The RPA bot fetches relevant information from various systems for each case and presents it in a structured form. This automation reduces manual data entry and toggling between multiple applications.

·      Human Intelligence: The team’s expertise remains critical in overseeing the process, making nuanced decisions, and handling expectations. Automation supports their work but doesn’t replace human insight. Human intelligence captures unstructured data from the knowledge base, which is vital for enabling informed decision-making. (For Phase 2 of the project, the focus is on enhancing the system’s ability to extract and leverage this unstructured data, further empowering automation to handle complex information and support more accurate and efficient decisions.)

·      PowerApps: Microsoft PowerApps act as the communication bridge between RPA and human analysts. It provides a user-friendly interface where the retrieved data by the bot is displayed, and the SME can add minimal additional information, mostly via dropdown options. Once the SME submits the form, their job is done! This process ensures seamless communication between automated data retrieval and human decision-making, enabling a smooth and efficient workflow.

The Big Win

Thanks to these collaborative efforts, the number of manual steps dropped significantly. Instead of toggling between multiple applications, the process now involves fewer manual interventions. The time to process a case is now reduced from 18 minutes to about 15 minutes – a reduction of approximately 16.67% – saving valuable time and reducing errors.

That’s the story of how automation transformed a slow, manual process into something quicker and more efficient. It’s a small change with a big impact, and it shows what’s possible when we walk in our customers’ shoes and dare to find better solutions – all the while playing strong as one.

With the increase in efficiency and reduced processing time, the Health Claims Pre Authorization Team handling the DCA process can now dedicate more time to what truly matters – helping the policy members prioritize their health.

Voices of Trust

“Working with the AXA GBS automation team has been a really exciting and valuable experience. We worked really well together as a team to problem solve and I was really fortunate to be in Bangalore when the demo was ready for sign off. I use automation in another process that I am responsible for but hadn’t ever seen automation in action. I was amazed at how slick, accurate and intuitive it is and could immediately see the benefit of this RPA.

All of the project team were fantastic, and we built some really great relationships together, with a fantastic automation that is running smoothly since launch. It has made me excited to see what is next, and how this team can support with making our lives a little easier with future automations.”

Melanie Byrne

AXA Health