Health Insurer Cuts Delegate Reporting Costs by 90% with Robotic Process Automation
Challenge
One of the largest US private health insurers, with more than 11 million insured members and 50,000 employees, relied on a team of 10 people to manually solicit and process monthly compliance reports from 400 delegated healthcare providers. The process ran entirely over email, was error-prone, and lacked an API to automate any part of the workflow — creating a costly bottleneck in the insurer's delegation oversight program.
The insurer needed a new platform that could be fully branded as its own rather than a third-party service like Dropbox (which delegates' security teams often blocked), meet strict encryption requirements for the PII and HIPAA data in the reports, require no software installation for delegates, and expose a REST API so the insurer's own data-aggregation application could be notified automatically when new reports arrived.
Solution
The insurer selected eSHARE, deploying it as a white-labeled, web-based portal that delegates could use with no plug-ins or account setup friction. eSHARE's script interface let the insurer prototype the workflow manually with a small group of delegates first, validating adoption before its REST API was used to fully automate report intake and hand off to the insurer's internal validation and aggregation systems.
Results
- Administrative costs tied to delegate reporting were reduced by roughly 90%
- The insurer's branding remained front and center throughout the delegate experience, avoiding the mistrust of a third-party file-sharing service
- Automation via the REST API eliminated the manual, email-based bottleneck across all 400 delegated providers