Healthcare Member Enrolment

Enhance member enrolment experience and ensure compliance for payers

Member enrolment is a time-consuming process that is ridden with errors due to manual processing of applications. Payers risk non-compliance if they don’t meet mandated timelines and face revenue loss if they are unable to handle peak loads. To enroll a new member, the analyst processes paper-based or scanned applications – the task involves extracting relevant data from forms, validating the data and mapping it to corresponding fields in downstream applications.

Wipro HOLMES^TM provides insurers a scalable solution to process enrolment applications, with considerably reduced cycle time. This makes the experience pleasant for the prospective members and cost effective for the payers. HOLMES utilizes ML and NLP algorithms to auto-classify forms, and extract relevant information. It also assigns confidence scores for the extracted values, with the provision for the analyst to make any corrections to extracted data. The validated data can then be exported to a chosen file format for further processing.

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