Smart Automation for Health Insurance

Health insurance is a complex industry to navigate with myriads of hurdles in the form of processes tangled with regulation, and age old legacy systems. While automation has become the new normal in a world of digital business, health insurance has lagged behind. Even the technologically advanced payers are crippled with greater operational cost, poor customer experience, higher cycle time, and a tangled back office. It’s now time to run at the speed of arising opportunities and fully embrace the phenomena of smart automation.

With the above thought in mind, Coforge has built its healthcare smart automation capabilities leveraging our in house framework – TRON, and partners like Pega, UI Path, Automation Anywhere, and Appian to automate processes in core areas like sales, quote to card, enrolment, consumer engagement, claims processing, referrals and authorisation, payment integrity, and case management – ultimately delivering a superior customer experience.

Our Solution

We approach automation holistically across the business and IT processes through a host of solutions and services including our end to end smart automation framework— TRON, allowing us to deliver a comprehensive mix that integrates class-leading partner products and our in-house solutions. This allows us to bring best-in-class technologies/IPs, autonomics, and their orchestration in business with an objective to increase automation and/or set an incremental automation path for creating agile outcomes and adding value. Further, TRON has an in-built maturity assessment model component that helps customers build a pragmatic roadmap to automation while leveraging their investments on toolsets. We also help existing and new clients develop an automation strategy focused on all key functional areas. Our expertise in developing and deploying bots is a cherry topping the automation paradigm; whether it be a first-level engagement in customer service or the more complex claims processing and adjudication, our bots can make it a breeze.

The ambitious approach for a holistic enterprise transformation is bolstered by our strategic partnerships with best-of-breed OEMs like UiPath, Pega, Appian, Microsoft, Automation Anywhere, and the likes. This lets us bring in top-notch capabilities around BPM, case management, RPA, and CRM, allowing payers to deliver an unmatched customer experience with ease. Our industry knowledge aligns in concert with the technical expertise to tailor a solution package that works in harmony with your existing systems.

Smart Automation for Health Insurance


TRON for Healthcare Transformation

Coforge’s TRON is an integrated automation platform that delivers more value by consolidating innovative technologies, practices, and tools for Healthcare transformation. Our automation capabilities have transformed enterprises spanning across industries, turning them into the smart organizations of the future. Leveraging advanced technologies like Robotic Process Automation (RPA), Analytics, Machine Learning, and Artificial Intelligence (AI), TRON platform will enable payers to deliver business agility, self-enablement, and superior experiences. Automation has been a major enabler impacting Healthcare leading to cost take-outs and reinvestments in strategic areas. However, there is a greater need to move from siloed to systematic automation of processes for handling scale without compromising on the quality and consistency of service. A unifying component of our Smart IT initiative, TRON seeks to fulfill IT automation promise through an integrated enterprise automation platform that leads to agile, efficient, and responsive enterprises.

Smart Automation for Health Insurance


The Coforge Advantage

Coforge, with our deep industry knowledge and core expertise in automation, can customize a smart automation strategy that is aligned with your organization’s business goals. We address specific automation needs of customers while removing the dependency on a single proprietary platform/approach, this allows us to pick and choose from the best and tailor a customized fit for your organization. We have a dedicated automation practice that owns an enterprise automation roadmap, enables automation institutionalization across all verticals, manages partnerships and alliances, and explores innovative automation technologies. We maintain an industry-leading certification standard that reinforces our partnerships with OEMs; having the highest percentage of certified resources across any Pega practice or being consistently ranked 1st in Appian’s A-Score program are testimonies to our partnership commitment.

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