Accelerating the Claims Process

If there was a way to cut not just days, but weeks off your work processes…wouldn’t you do it? Elevate has done it. Currently, TPAs, health care plans, and financial institutions are cutting into profit margins by using over 30% of operating budgets for administrative and service costs for health savings accounts (HSA), flexible spending accounts (FSAs), and health reimbursement arrangements (HRAs). 

In fact, in the traditional model, a single claim in the claims process takes up to 25 days to complete. With Elevate, this is condensed to under two minutes. Two minutes!‍

The difference is clear – Elevate’s speed not only improves the benefits experience for members, but it also allows administrators to meet needs faster, serve more members, and use time to complete other tasks that require a human touch.

Let’s look at the steps:

Claims submission

Traditional process (10 minutes): Clunky process with paper forms or manual data entry
Elevate process (20 seconds): OCR and AI automatically complete claim form

‍
For employees, the process of submitting benefit account reimbursement requests can be difficult. Complex paperwork, manually entering data, and then waiting weeks or even months for reimbursement is not only frustrating but can also create financial strain.

With Elevate's user-friendly platform, the once time-consuming claims submission has changed into an almost instantaneous experience.

In the traditional model, employees spent an average of 10 minutes dealing with paper forms or manually inputting information into outdated systems. This process was not only inefficient but also prone to errors, which could also delay reimbursement.

Elevate's technology eliminates these issues. Using Optical Character Recognition (OCR) and artificial intelligence (AI), Elevate's platform can automatically extract relevant information from receipts, invoices, and other supporting documents. This data is then used to populate the claim form accurately and efficiently, reducing the submission time to only 20 seconds.

This improvement is a giant benefit to claims administrators. By automating data entry and reducing the potential for human error, claims administrators can now spend less time on manual verification and more time on complex assessments. It’s more than time savings – by simplifying the process improves the overall accuracy of claims. As a result, claims administrators can more efficiently get clients their money.  

Document review

Traditional process: (2-5 days) Manual review by claims processor. Dependent on work queue.
Elevate process: (10 seconds) HIPAA-compliant AI reads and reviews documentation

The document review stage in the traditional claims process is a common bottleneck, often taking 2-5 days. It’s heavily dependent on the workload and prioritization in the claims department. This manual review process not only delays reimbursements for employees but also puts pressure on claims administrators, who need to comb through each document to verify eligibility and compliance. Plus, there’s the additional cost of starting these departments in the first place. 

Elevate's AI-powered document review changes this step. With HIPAA-compliant artificial intelligence, Elevate can instantly analyze and interpret a wide range of documents, including receipts, invoices, medical bills, and Explanation of Benefits (EOBs). Within 10 seconds, Elevate’s AI can accurately extract relevant data, verify eligibility criteria, and flag any potential discrepancies.

Requests for more information

‍Traditional process: (5-8 days) Mailed or emailed notice asking for additional documentation; often unclear and confusing
Elevate process: (20 seconds) On-screen feedback in clear, simple language

In the traditional claims process, requesting additional information from employees is a difficult process. The need for more information can happen for a variety of reasons, like the documentation isn’t approved or is missing information. Mailed notices can take days to reach employees, and if the requests are unclear or confusing to the recipient, it can lead to more delays and aggravation. 

Elevate changes this process. When additional documentation is required, employees receive instant on-screen feedback within the platform. This feedback is presented in clear language, helping employees understand exactly what is needed and how to provide it. This gets rid of the confusion and back-and-forth communication that often happens during the traditional process. It makes quite a difference.  As Elevate cofounder Brian Strom said, “Before our AI coaching, about 12% of our reimbursement requests would get returned to the participants asking for better documentation. With our AI coaching, less than 2% are returned.

Getting rid of the need to send and track mailed or emailed notices reduces the administrative overhead associated with requesting additional information. By providing instant feedback and eliminating communication delays, Elevate accelerates the claims process. Employees can quickly provide the necessary documentation, leading to faster resolution and reimbursement. 

The clarity of Elevate's requests also minimizes the chance of employees submitting incorrect or incomplete documentation, which reduces the need for follow-up requests and rework.
‍

Document re-review

Traditional process: (2-5 days) Manual review by claims processor; work queue dependent, may go to back of line
Elevate process: (10 seconds) HIPPA-compliant AI reads and reviews documentation

When employees submit additional documentation, it often enters a queue for manual review, adding days to the overall processing time and creating a backlog for claims administrators. Elevate's AI-powered document re-review process eliminates these delays and inefficiencies. 

When employees submit additional documentation, Elevate’s HIPAA-compliant AI immediately re-reviews it, making sure all necessary information is present and accurate. The AI also ensures all submitted documentation is compliant with relevant regulations. 

By instantly re-reviewing documents, Elevate prevents claims from waiting around in queues for someone to get to them. Plus, AI’s instant review capabilities reduce the time it takes to process claims with additional documentation. By automating the re-review process, Elevate frees up claims administrators from repetitive tasks so they can focus on more strategic work.   

Payment

Traditional process: (2-7 days) Mailed check or ACH to account 
Elevate process: (Real-time) Venmo, PayPal, or push to debit card 

The final stage of the claims process can seem long for employees who have already endured a lengthy waiting period. In the traditional model, payment is typically issued by mailed check or ACH transfer, taking anywhere from 2-7 days to reach the employee's account. This delay can be a problem for people with tight budgets.

Elevate's real-time payment options change this step of the claims experience. By offering instant disbursements through popular platforms like Venmo, PayPal, or direct deposit to debit cards, Elevate makes sure employees receive their reimbursements as soon as their claims are approved. 

For claims administrators, Elevate's real-time payment options offer significant advantages:

• ‍Reduced overhead: By eliminating the need to print, mail, or process checks, Elevate reduces the administrative burden associated with payment disbursement. ‍
• Improved cash flow management: Real-time payments provide greater visibility into cash flow, allowing claims administrators to track disbursements more accurately.

Finallly providing payments in a modern way, Elevate improves the claims experience for employees while reducing costs for administrators.
‍

Total time

Traditional process: Up to 25 day
Elevate process: Under 2 minutes

__________________________________

With AI, Elevate slashes processing times from weeks to minutes. Elevate's solution addresses every stage, from claims submission to document review, requests for information, document re-review, and finally, payment.
‍
Elevate’s advanced systems and workflows not only get money to account holders faster and boosts their satisfaction, it also  bring a variety of benefits to claims administrators:

• Speed: By eliminating the need for manual review, Elevate helps administrators accelerate the claims process, changing turnaround times from days to seconds. This allows administrators to handle a higher volume of claims without increasing their workload.
• Accuracy: AI's ability to cross-reference information gives it a higher degree of accuracy and compliance than manual review. This reduces the risk of errors, overpayments, and fraudulent claims, and helps protect the financial integrity of the benefits program.
• Productivity: By automating the document review process, Elevate frees up claims administrators to focus on more complex tasks that require human expertise. 
• Analysis: AI can analyze large volumes of data and provide information on claims trends, usage patterns, and possible cost-saving opportunities. Claims administrators can use this information to make decisions about resource allocation.  
• Fewer questions: By providing immediate access to funds, Elevate minimizes the number of inquiries and disputes related to payment delays, freeing up time for claims administrators.   

When you partner with Elevate, you’re not just investing in a platform – you’re choosing a future where claims administration is synonymous with speed, accuracy, and satisfaction. Finally.    
‍

Check out our infographic showcasing how we shrink the claims processing timeline.

‍