Leading US Health Insurance Provider Partners with Skan to identify appeals process deviations and automation opportunities

  • IndustryHealthcare Payer
  • Company Size 10,000+
  • Revenue $6B+
  • Location United States

Our Client

This Fortune 50 company leverages technology to provide health insurance for over 150+ million people across the U.S. For their customers, they merge the power of data with a full range of benefits to improve the healthcare experience from top to bottom.



The objective was to optimize the appeals process to enhance productivity. The client tackles appeals resolutions across various healthcare plans, navigating a complex process with multiple start and end points, high volumes, and time-sensitive redressals. The organization sought to streamline operations by identifying automation opportunities to improve efficiency at each case processing stage. Additionally, they aimed to pinpoint and eliminate non-value-added activities during case processing as well as deviations from standard operating procedures by users and teams.

Cost Savings

in potential savings identified from automation

Saving Opportunity

per participant potential savings identified



Skan delivered new process understanding of the turnaround times (TATs) for processing various case components. By highlighting the time invested in each sub-process and task during case processing, Skan empowered the client with an intimate understanding of their workflow.

Through a detailed analysis of application utilization, event switches, application switches and task switches, Skan provided a clear picture of the inner workings of the client's appeals process. Skan's expertise guided the client through a maze of metrics to reveal actionable ways to optimize performance.

The insights Skan shared sparked new possibilities in the client's mind. Skan's collaborative approach ensured the client walked away with clarity and confidence to drive meaningful improvements.



With Skan's keen insights, the client uncovered significant 37% reduction in case processing time and savings opportunities - over $11,000 per participant per year. Skan revealed the precise scenarios where automation and integration could streamline operations. Even more, Skan highlighted specific process sequences packed with unexpected, redundant steps ripe for optimization.

With Skan's meticulous analysis, the client gained clear visibility into estimated savings of $6.5M from automation opportunities. By leveraging Skan's expertise, the client is now equipped to boost efficiency and cut costs dramatically.

Similar Posts

Subscribe to our Newsletter

Unlock your transformation potential. Subscribe for expert tips and industry news.