Automating Insurance Reimbursement for Efficiency and Growth

Automating Insurance Reimbursement for Efficiency and Growth

Timeline

Nov 2023 - Feb 2024

Role

Product designer, Research

Description

We needed to automate the manual insurance reimbursement workflow to ensure timely payouts, reduce costs, and improve efficiency.
We needed to automate the manual insurance reimbursement workflow to ensure timely payouts, reduce costs, and improve efficiency.

Context

Ayu Health assists patients seeking insurance reimbursement by partnering with banks that offer loans to them as a result, Ayu Health transfers the loan amount from the lender to the hospital (Payable) & receives a service fee from the hospital (Receivables). Ayu Health handles the entire Claim process, right from claim submission to claim settlement. When the claim is settled, we inform the lender to debit the Loan amount from the patient’s account.
Ayu Health assists patients seeking insurance reimbursement by partnering with banks that offer loans to them as a result, Ayu Health transfers the loan amount from the lender to the hospital (Payable) & receives a service fee from the hospital (Receivables). Ayu Health handles the entire Claim process, right from claim submission to claim settlement. When the claim is settled, we inform the lender to debit the Loan amount from the patient’s account.
This workflow is managed manually by a team of 4 people. Due to the rapid growth in cases from 300 to 1200 per month (a 10% increase month-over-month) as we expanded into new cities, Ayu Health’s payouts to hospitals were delayed by 3-5 days.
This workflow is managed manually by a team of 4 people. Due to the rapid growth in cases from 300 to 1200 per month (a 10% increase month-over-month) as we expanded into new cities, Ayu Health’s payouts to hospitals were delayed by 3-5 days.

Solution

Built a Product which automated the entire manual workflow of Capturing Commission information from hospital agreement, generating invoices and credit/debit notes, automatically initiating payments by auto-adjusting outstanding receivables with payables, Triggering email notifications for invoice and disbursal information.
Built a Product which automated the entire manual workflow of Capturing Commission information from hospital agreement, generating invoices and credit/debit notes, automatically initiating payments by auto-adjusting outstanding receivables with payables, Triggering email notifications for invoice and disbursal information.

Outcome

Instant payouts worth INR 75 million to 250+ hospitals, Reduction in finance team manpower costs from 4 to 1, Improved hospital customer satisfaction (CSAT) score of 4/5.
Instant payouts worth INR 75 million to 250+ hospitals, Reduction in finance team manpower costs from 4 to 1, Improved hospital customer satisfaction (CSAT) score of 4/5.

Designs

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