Introduction
A Fortune 500 payer providing access to care in more than 200 countries and territories needed to offer a seamless claims process to over 20 million multilingual members quickly and accurately.
The Challenge
With an average of 9,000 medical claims requiring translation coming in from over 200 countries per month, our client was looking to optimize its conventional human translation process to reduce costs, save time and improve the member experience.
Our client also needed to maintain a quality rating of 99.5% accuracy in all medical translations to meet regulations administered by individual state public health agencies.
To resolve these volume, quality and turnaround-time challenges, a radically new process was called for.
“Propio is outstanding! Their Medical Claims Platform is easy to use, and the turnaround time is very quick. Major improvement.”
— Client Representative
The Solution
Leveraging a human-led, AI-enabled approach, Propio implemented its flexible Propio Medical Claims Platform to process medical claims translations more quickly and efficiently without sacrificing quality. The platform made it easier for users to submit claims and enabled a new continuous translation process:
- Using language identification technology, the platform quickly assesses and assigns each project to the correct language resources.
- Optical Character Recognition (OCR) then reads images from scanned or faxed content, rendering them as editable words that can be translated through the platform’s curated healthcare Neural Machine Translation (NMT) engines.
- Once translated, trained project managers and processors identify key data points to extract, such as medical services, dates and costs, and provide them seamlessly to the user in a simple template.
Propio integrated the Medical Claims Platform with the client’s systems through an Application Programming Interface (API), increasing the speed at which claims were handled and creating a simpler, more efficient user experience. The integration created a virtually hands-off process for the client to submit translation requests and for Propio to deliver the translated content.
Propio coupled these tools with a dedicated multinational project team to maximize efficiency and quality. Through this approach, Propio reduced both the turnaround time and costs associated with the client’s claims process while improving the translation portion of its claims workflow.
“I love how easy it is to send the documents to be translated in the Propio Medical Claims Platform. So much better than how we were doing it before!”
— Claims Agent
Proven Results
The development and deployment of Propio’s comprehensive, dedicated Medical Claims Platform succeeded in addressing the client’s needs while enhancing the user experience and maintaining the standards expected for medical claims translation quality.
Specifically, Propio was able to deliver:
- A 30% reduction in translation costs associated with claims processing.
- A decrease in average translation turnaround time from 36 hours to 12 hours.
- 100% on-time translation delivery.
- Quality KPI performance exceeding the 99% requirement.
