Digital Claims Operations | Claim Processing
Project Type
Explainer video
Client
Firstsource
Service
Style Frame, Illustration, Motion Graphics, HUD
Project brief
Firstsource’s proprietary workflow platform Sympraxis automates the claims operations process, boosting accuracy and efficiency and accelerating cycle time – ultimately delivering a better member experience. The digital-first solution auto-loads Provider data, auto-adjudicates and auto-audits claims, and automates member benefit coding – ensuring first-time-right processing.
Problem Statement
Operation teams review claim denials from payers, identifying the need and scope of appeal, and moving the claim to appeal queue which is accessed by a claim specialist to retrieve key information and update the payor claim review form. The form is fed back into the system to file the claim via EDI with the payor which increases cycle time for claim review submission and is inefficient.
Solution
Our team eliminated the need for human intervention issues by deploying an automated solution to fill in the claim review form and improved productivity and reduced cycle time for claim appeals.
Tech Specs
Claim Review & Appeal CoBot is an unattended digital employee that uses RPA to submit claim denial review forms and offsetting the need for human intervention.
Expertise
Claims that need an appeal to be filed are populated based on standard rules in the claim review form for denial submission
Style frame
Responsible for planning, guidance(to the creative team) & executing the project from start to finish.
Art directing the project, developing the design style for video, illustrations, HUD and key animation style.
Client brief
The client wants this video to be instructive and detailed, showcasing the process flow effectively. Additional features should be highlighted intuitively using footage, graphics, and diagrams.
We selected footage from Getty Images according to the scenarios and shots. For diagrams and process showcasing,
I used HUD-style UI elements, which I believe are more precise and flow well with the overall theme of the story."
Creative slides
Conclusion
We created our first draft in two weeks and will finalize it with some additional shots and changes in the upcoming week.
We learned many new techniques and styles to make this possible in such a short time period. We used Illustrator and Photoshop for all illustrations and graphics and After Effects for motion.
