Executive Summary
A leading health insurance company sought to address the challenges policyholders faced during hospitalization and claims settlement. These challenges included the complexity of documentation, the need for immediate medical care, and navigating healthcare regulations. To improve the policyholder experience, the company integrated Third-Party Administrator (TPA) into its health insurance offerings and implemented a robust Salesforce portal solution. This initiative aimed to provide continuous support, streamline documentation through a centralized system, and enhance the efficiency of the claims process. As a result, the company significantly improved customer satisfaction, operational efficiency, and regulatory compliance.
Project Highlights
- 24/7 support for policyholders through the portal, enhancing customer care.
- Expert guidance on claims documentation reduced errors by 35%.
- Seamless cashless claims settlement, improving processing times by 50% via automated portal workflows.
- Leveraged TPA expertise in healthcare regulations through integrated compliance checks within the portal.
- Enabled access to network hospitals without upfront payments, increasing usage by 45% through portal-facilitated transactions.
