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FNOL correspondence forms a critical aspect of setting up and and effectively managing a claim.
Documents received as part of FNOL vary from structured forms (e.g. ACORD, UB-04, CMS-1500 etc) to completely unstructured documents (e.g. demand letters, policy documents, general correspondence etc).
Additionally, seasonal events, such as CAT season, often result in large volume spikes that exceed the existing team’s capacity slowing down the FNOL process or worse, resulting in rework or inaccuracies that drive up premium leakage.
Challenges include
High variability of documents and data that are unclassified
Multiple channels used to submit documentation
High manual effort to extract data from both structured and unstructured data sources
Quality and/or types of documents submitted (e.g. images) cannot be processed by traditional automation or OCR tools
During times of peak volumes, claims teams are forced to turn to temp labor.
Transform FNOL processing
See how we reimagine FNOL processing for claims teams.
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Intake
FNOL correspondence and documents are submitted directly to a Digital Coworker for scanning, classification, analysis and key data extraction.
Traditionally, the mailroom, imaging team or adjuster receives the FNOL package, identifies key information and manually enters the data into the claims/policy system. Further, the adjuster may need to open up a communications channel with the customer or agent to clarify or obtain more information.
In this future state, the Digital Coworker ingests the FNOL package and leverages InsurGPTTM to classify each document type, look up existing claims or cases, extract key information (such as claimant name, policy number, claim amount, reason for claim etc), upload relevant documents and data to systems of records and finally, create the acknowledgment letter.
Further, the Digital Coworker can be trained to identify missing data and as part of the initial acknowledgment, request required information.
The Digital Coworker notifies the claims team, via the Roots Cockpit, that a FNOL has been received and is ready for review.
The claims team uses the Roots Cockpit to communicate with and assist the Digital Coworker in finalizing the FNOL acknowledgment and can either action themselves or pass to a Digital Coworker to complete the process.
Digital Coworkers can effectively automate the FNOL process end-to-end, liberating your claims team from the administrative burden that comes with managing this highly unstructured, manual process.
Process FNOL straight-through
Reduce administrative cost and premium leakage
Provide the organization with a scaling workforce to address capacity issues, especially during seasonal or unforeseen events
Remove manual effort and provide capacity back to highly skilled employees, to spend more time on claims handling, adjudication and customer engagement
Our Customers see Digital Coworkers as important members of their team
“The Digital Coworkers Roots Automation provides work in conjunction with our Team to optimize our medical claims process. Our Digital Coworkers provide the simplicity and scalability necessary to deliver best-in-class productivity to our clients. Additionally, we value the insights from the Roots Automation Team about our processes, of which, we integrate into our continuous improvement plans for our business practices in order to provide industry leading solutions.”
Kevin Mahoney
President & COO, Carisk Partners
“Everything happened fast, our digital coworker ‘Roxy’ was trained and ready on time as promised! The team at Roots Automation have been a pleasure to work with! They’ve anticipated our questions and respond quickly to our asks and changes.”
Lea Lundquist
VP, Claims Administration, Protective Insurance
“We appreciate all of Roots Automation's efforts to automate a challenging initiative with 500,000+ transaction requests annually. Our internal Center of Excellence was able to get to production faster and more cost-effectively than what we originally planned.”
David Emmer
CIO, Anchin, Block & Anchin LLP
"Insurance companies have a desperate need to automate many business processes for efficiency, but current solutions are limited to rule-based tasks and aren’t insurance industry-specific, limiting their potential, Digital Coworkers lessen our stress over finding and retaining talent, and unburden our teams so they can focus on more impactful work. Roots Automation’s unique approach to automation has improved our employee retention while offering superior economics and enhanced customer experience".
Cathy Raitter
VP of Insurance Support Services, Berkshire Hathaway Guard President
"Roots Automation has helped American Exchange automate and improve a lot of our internal data validation and data entry processes. This has both reduced our workload and has reduced human data entry error to almost zero. The best part is that our process with Roots Automation has allowed our agents to do what they do best, and that is talk to people and help them with their individual and Medicare health insurance decisions."
Andrew Hetzler
Chief Executive Officer, American Exchange
“We began our relationship with Roots in 2022 as part of a larger corporate strategy to use technology to be more efficient and to better serve our customers. With Roots, they're only focused on the insurance industry. They could talk our language and lead us through different workflow options; they knew the challenges we would face and we made quick decisions in a short timeframe. It was very rewarding, in the end, to have deployed the first Digital Coworker at Eastern. I'm very proud. We solved the core use case problem and accomplished our goal of implementing AI into Eastern Alliance.”
Harry Talbert
Senior Vice President of Information Systems, Eastern Alliance
INSIGHTS, NEWS & RESOURCES
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Whitepaper: Solving the Insurance Industry's Unstructured Data Challenge with AI
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Success Story
Increasing speed & accuracy of Claims Document Processing for a large Insurance Conglomerate
Whitepaper: Solving the Insurance Industry's Unstructured Data Challenge with AI
Turning natural language information into actionable decision-data
Roots Automation at ITC Vegas 2024
What would you do if you had 100x capacity, accuracy, speed across your claims and underwriting operations?
Increasing speed & accuracy of Claims Document Processing for a large Insurance Conglomerate
Our Customer chose to adopt a Digital Coworker due to its ability to ingest and make sense of a significant amount of data held within structured and unstructured claims documents.