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How Payers Improve Agility and Compliance Through Intelligent Automation

Authored by: Zach Tabor

As a health care payer, you face many demands, including the need to work faster, improve efficiency and reduce compliance risks. You have other struggles, too. You’ve got to keep up with all the mergers and acquisitions happening across the industry. You also need to get all your technology to talk to each other so you can avoid expensive and frustrating timewasters –like employees having to continually switch from application to application to find the information they need to do their jobs. 


Successfully navigating these and future challenges requires agility, according to a report published by McKinsey and Company. Being agile helps organizations do a better job of handling uncertainty, reduces costs and makes it easier and faster to respond to changing customer expectations – all of which is critical to remaining competitive. Research shows that 81% of payers say they’re investing in technology to improve the member experience. 


So, where should you start? 

Intelligent automation: Why it’s the key to payer agility 

Intelligent automation simplifies processes and untethers your employees from repetitive and tedious tasks. As you free employees from this type of lower-level work, you reduce risks, such as human error, and support happier workers. And keeping your employees happy is vital when 44% of employees admit they’re looking for a new job. A few more ways intelligent automation helps include: 

  • Offloading repetitive tasks. Low-value, mundane tasks are exactly the type of work that intelligent automation was created to handle. For example, your employees might create incoming cases manually, each taking an hour to create. Automation might reduce that time to 10 minutes — saving 50 minutes per case. If you process 20,000 cases annually, that time-savings adds up fast. 
  • Getting rid of the need to “system jump.” When employees must constantly switch between systems, valuable productivity is lost. Intelligent automation gives employees a centralized location from which they may quickly access the data required to finish the work. Technology that integrates with systems such as DocuSign, Outlook and others keep workflows moving smoothly. 
  • Completing necessary changes within your department. Your IT department is busy, and while you may need changes made right now, getting them done can be time-consuming. With the right intelligent automation solution, you make changes within your department and don’t need to wait on IT to complete the required tasks. 

Intelligent automation helps speed productivity, but these faster workflows also come with another benefit: improved compliance. 

Mitigating potential compliance risks   

You do your best to stay compliant, but manual processes always introduce the risk of human error. And with federal regulations such as the No Surprises Act and the recent CMS interoperability rules, the need to reduce compliance risks has only become more important. 


Intelligent automation helps reduce compliance risks by reducing the time it takes to complete tasks. This increased speed helps address member needs faster – all while staying within any processing time regulations. And when it comes time for an audit, you can handle inquiries faster and with fewer employee resources. 

The path to adoption: Best practices to consider 

As you streamline more processes, integrate with other technology and improve your workflows, you’ll significantly improve efficiency. But as you consider the path to intelligent automation, here are a few things to consider: 

  • Commit to moving to digital. If you’re still using spreadsheets, you’re not alone. However, with every spreadsheet you use, there is increased risk of manual errors and decreased productivity. Transitioning to a digital approach with tools such as intelligent automation helps mitigate these risks. 
  • Embrace continuous improvement. Why wait for an outside audit? Using digital tools to internally audit your processes and continuously improving workflows will help you streamline processes and stay compliant, so you’re always ready for that next external audit. 
  • Think big but start small. After seeing everything intelligent automation can do for your workflows, it’s easy to become a bit overwhelmed. Start small and build on those successes, applying your knowledge to other processes and areas of your business. 

As you adopt new technology, you might run up against hurdles within your organization. There will be those who either believe everything is fine as it is and others for whom even the idea of change sparks a sense of fear. 


Here’s the thing: Uncertainty is the only thing certain about the future. When you deploy tools that help you become more agile you’re better positioned to meet uncertainty. This flexibility and efficiency provide a competitive advantage over those organizations who don’t embrace change. Even if that change is to employ the kind of proven technology that helps them grow their business now and well into the future. 


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