For health insurers to be more efficient and control administrative costs, it's important to simplify upstream complexity to make the downstream processes easier. Furthermore, members increasingly demand a responsive, personalized experience when engaging with services. And they expect added value to their healthcare journeys, every step of the way.

Enhanced claims processing and auto-adjudication with intelligent automation

Claims processing represents one of the highest administrative costs in the US healthcare payer industry. The claims environment for every insurer relies on the accuracy and speed of processes to meet its obligation to members. CGI's claims processing and auto adjudication services are fueled by intelligent automation and helps clients optimize claims processing by harnessing technology more effectively to make impactful changes to auto adjudication rates.

CGI's approach to claims processing focuses on your workforce, your processes and the best mix of automation technology. Our Robotic Process Automation (RPA) experts bring deep knowledge of leading vendor technologies (such as BluePrism, UiPath, Pega, Automation Anywhere, Kapow and Work Fusion, among others), along with our own RPA technology, part of CGI’s proprietary Intelligent Automation Platform.

Furthermore, CGI has a rich history and deep experience in supporting industry standard medical claims solutions and applications, such as PowerMHS, in addition to home grown claim applications. CGI is supporting a medical claim engine with over 10 million active members and processing approximately 500,000 claims every day with ~87% auto adjudication rate.

CGI helps modernize your claims processing environment to process claims with sufficient speed and accuracy so you can reduce or eliminate duplication errors for an accelerated ROI.