Claims management for a top health insurer in Hong Kong

Qantev helps one of the top 10 Hong Kong health insurer increase its straight through processing rate

This insurer in Hong Kong offers a range of health insurance plans tailored to individuals, families, and businesses (employee benefits). Known for their comprehensive coverage, they provide access to an extensive network of healthcare providers and facilities. Their services include outpatient and inpatient care, wellness programs, and international health insurance options. With a focus on customer support and innovative solutions, this insurer aims to ensure that policyholders receive the best possible care and support throughout their health journey, the reason they have adopted the Qantev platform to streamline their operations and leverage artificial intelligence.

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The insurer is facing challenges in order to reach its ambitions, mainly caused by the reliance on non-flexible legacy systems, causing processes to be manual.

• Large majority of claims processed manually
• Lengthy claims turnaround time
• 5% estimated leakage from fraud, waste and abuse
• Impacted by medical inflation

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They have chosen to adopt the Qantev platform to overcome their challenges and set the stage for their digital transformation, fully deployed and operation within 6 months

• Deployment of the Qantev claims management module 
• Deployment of  the Qantev fraud, waste and abuse  module
• Deployment of the Qantev OCR & data acquisition module

Qantev has enabled this insurer some rapid and tangible business results

• 45% straight through processing rate achieved in 12 months
• 85% of data acquisition processes automated
• 20M HKD cost savings in 12 months
• 40% reduction of the average turnaround time
• ‍Positive ROI after 4 months of production