Nintex Case Studies 75% Reduction in Time to Establish New Networks: A Case Study on Scott & White Health Plan and Insurance Company

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	75% Reduction in Time to Establish New Networks: A Case Study on Scott & White Health Plan and Insurance Company Nintex

75% Reduction in Time to Establish New Networks: A Case Study on Scott & White Health Plan and Insurance Company

Nintex

Technology Category	Analytics & Modeling - Robotic Process Automation (RPA)
Applicable Industries	Finance & Insurance Healthcare & Hospitals
Applicable Functions	Maintenance
Use Cases	Time Sensitive Networking Usage-Based Insurance
Challenge	Scott & White Health Plan and Insurance Company (SWHP), a Texas-based health maintenance organization (HMO) with over 215,000 members, was facing significant challenges with their manual data entry processes. The company was struggling with a large volume of manual data entry, which included copying and pasting data, setting up new pay classes, and establishing new provider networks. The passage of the Affordable Care Act (ACA) was expected to bring an influx of new applicants, which would further increase the time spent on manual data entry. The process of creating new networks involved copying and pasting rate, service, and other information from a similar plan into the new ones, a process that could take up to four weeks. Similarly, setting up new pay classes was a time-consuming task, taking up to 45 minutes per job. Read More
About Customer	Scott & White Health Plan and Insurance Company (SWHP) is a health maintenance organization (HMO) based in Temple, Texas. With a history of healthcare service in Texas dating back to the late 19th century, SWHP is part of Baylor Scott & White Health. The organization serves more than 215,000 members and is the highest-rated plan in Texas and one of the highest-rated plans in the nation. SWHP is consistently recognized for member satisfaction and enjoys a national reputation for excellence. Despite being a small team for a plan of their size, they are able to be highly productive and scale their operations quickly. Read More
Solution	SWHP turned to Nintex Foxtrot RPA, an automated solution that they were already using, to handle the task of pay class set-up, provider network creation, and more. Nintex Foxtrot RPA works in the presentation layer of most core systems, performing tasks just like a human would, but with greater accuracy. By assigning their 'automated employee' to these tasks, SWHP was able to significantly reduce the time spent on manual data entry. The software was able to establish new networks in just one week, a 75% reduction in time. Setting up new pay classes, which previously took up to 45 minutes, now took just five minutes with the automated solution. Nintex Foxtrot RPA also handled claims affected by retroactive pricing changes, automatically re-running them and issuing checks for the fee difference. Read More Log in to view content
Contents

Technology Category

Analytics & Modeling - Robotic Process Automation (RPA)

Applicable Industries

Finance & Insurance

Healthcare & Hospitals

Applicable Functions

Maintenance

Use Cases

Time Sensitive Networking

Usage-Based Insurance

Challenge

Scott & White Health Plan and Insurance Company (SWHP), a Texas-based health maintenance organization (HMO) with over 215,000 members, was facing significant challenges with their manual data entry processes. The company was struggling with a large volume of manual data entry, which included copying and pasting data, setting up new pay classes, and establishing new provider networks. The passage of the Affordable Care Act (ACA) was expected to bring an influx of new applicants, which would further increase the time spent on manual data entry. The process of creating new networks involved copying and pasting rate, service, and other information from a similar plan into the new ones, a process that could take up to four weeks. Similarly, setting up new pay classes was a time-consuming task, taking up to 45 minutes per job.

About Customer

Scott & White Health Plan and Insurance Company (SWHP) is a health maintenance organization (HMO) based in Temple, Texas. With a history of healthcare service in Texas dating back to the late 19th century, SWHP is part of Baylor Scott & White Health. The organization serves more than 215,000 members and is the highest-rated plan in Texas and one of the highest-rated plans in the nation. SWHP is consistently recognized for member satisfaction and enjoys a national reputation for excellence. Despite being a small team for a plan of their size, they are able to be highly productive and scale their operations quickly.

Solution

SWHP turned to Nintex Foxtrot RPA, an automated solution that they were already using, to handle the task of pay class set-up, provider network creation, and more. Nintex Foxtrot RPA works in the presentation layer of most core systems, performing tasks just like a human would, but with greater accuracy. By assigning their 'automated employee' to these tasks, SWHP was able to significantly reduce the time spent on manual data entry. The software was able to establish new networks in just one week, a 75% reduction in time. Setting up new pay classes, which previously took up to 45 minutes, now took just five minutes with the automated solution. Nintex Foxtrot RPA also handled claims affected by retroactive pricing changes, automatically re-running them and issuing checks for the fee difference.

Impact #1	The implementation of Nintex Foxtrot RPA has significantly improved the efficiency of SWHP's operations. The software has taken over much of the time-consuming manual work, freeing up employees to handle other projects. The automation of tasks such as pay class set-up and provider network creation has not only reduced the time spent on these tasks but also increased their accuracy. The software also handles claims affected by retroactive pricing changes, automatically re-running them and issuing checks for the fee difference. This has allowed SWHP to maintain a small team while still being able to scale their operations quickly and efficiently.

Impact #1

The implementation of Nintex Foxtrot RPA has significantly improved the efficiency of SWHP's operations. The software has taken over much of the time-consuming manual work, freeing up employees to handle other projects. The automation of tasks such as pay class set-up and provider network creation has not only reduced the time spent on these tasks but also increased their accuracy. The software also handles claims affected by retroactive pricing changes, automatically re-running them and issuing checks for the fee difference. This has allowed SWHP to maintain a small team while still being able to scale their operations quickly and efficiently.

Benefit #1	Reduced new network set up time by 75 percent
Benefit #2	Time to establish new pay classes cut from 45 minutes to 5 minutes
Benefit #3	Automated solution allows SWHP to scale operations without adding headcount

Benefit #1

Reduced new network set up time by 75 percent

Benefit #2

Time to establish new pay classes cut from 45 minutes to 5 minutes

Benefit #3

Automated solution allows SWHP to scale operations without adding headcount

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Overview

75% Reduction in Time to Establish New Networks: A Case Study on Scott & White Health Plan and Insurance Company

Operational Impact

Quantitative Benefit