During the study period, the client recorded a total of 400,000 new claims received, not including recurring claims. This is an average of almost 1,000 new claims per day to be processed. Processing time for a single claim took approximately 20 minutes, thereby requiring almost 333 hrs to process 1000 claims a day.
In phase 1, Virtusa implemented the Pega Single View application, which centralized and brought together multiple systems and portals into a single interface providing ease, accuracy, and speed to the claim decisioning process. The processing time was expected to reduce by 10% or 2-3 minutes through optimization and centralization of multiple applications, although the actual time reduction is potentially much higher. Phase 2 wrapped the end-to-end claims workflow management around Phase 1 implementation, thus providing a seamless, efficient single interface for the management of claims.
Key highlights of the solution included: