AI Solution Reduces Medical Claims Translations Turnaround Time and Costs Without Sacrificing Quality  

Case Study 18 | Medical Claims Program

Introduction

A Fortune 500 payer providing access to care in more than 200 countries and territories needed to offer a seamless claims process to over 20 million multilingual members quickly and accurately. 

Chapter 1

THE CHALLENGE

With an average of 9,000 medical claims requiring translation coming in from over 200 countries per month, our client was looking to optimize its conventional human translation process to improve costs and save time, as well as optimize their member experience.    

Our client also needed to maintain a quality rating of 99.5% accuracy in all Medical Translation to meet regulations administered by individual state Public Health agencies.  

To resolve these volume, quality and turnaround time challenges a radically new process was called for.  

"ULG is outstanding! Their Medical Claims platform is easy to use, and the turnaround time is very quick. Major improvement."

- Client Representative

Chapter 2

THE SOLUTION

Leveraging a human led, AI enabled approach, ULG implemented its flexible ULG Medical Claims Platform to process the medical claims translation more quickly and efficiently without sacrificing quality. The ULG Medical Claims Platform made it easier for the user to submit a claim and enabled a new continuous translation process:  

  1. Leveraging Language Identification technology, the platform quickly assesses and assigns each project for the correct language asset application.
  2. Then Optical Character Reading (OCR), reads images from scanned or faxed content, rendering them as editable words that can be translated through the platform’s curated Healthcare Neural Machine Translation (NMT) engines.
  3. Once translated, trained Project Managers and Processors identify key data points to extract such as medical services, dates and costs and provides them seamlessly back to the user in a simple template. 

Together we integrated the ULG Medical Claims Platform through the client’s Application Programming Interface (API) to increase the speed with which claims are handled, leading to a simpler and more efficient user experience. This system integration between the two platforms created a virtually hands-off process for our client to submit translation requests and for ULG to deliver the translated content.  

ULG coupled these tools with a dedicated multinational project team to maximize efficiency and quality. By incorporating all the foregoing, ULG decreased both the turnaround speed of our clients’ claims process and their associated costs, as well as improved the experience for the translation part of the client’s claims workflow.  

"I love how easy it is to send the documents to be translated in the ULG Medical Claims platform. So much better than how we were doing it before!!"

- Claims Agent 

Chapter 3

KEY RESULTS

The development and deployment of ULG’s comprehensive, dedicated Medical Claims Platform succeeded in addressing the client’s needs while enhancing the user experience and maintaining the standards expected in medical claims translation quality. 

Specifically, ULG was able to deliver:  

  • 30% reduction in the translation cost associated with claims processing. 
  • Decreased translation turnaround times from an average of 36 hours to 12. 
  • Maintained 100% on-time translations delivery. 
  • Exceeded 99% requirement on quality KPIs. 

For more information: 

https://www.unitedlanguagegroup.com/healthcare-translation-services/medical-claims 

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