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Large health exchange boosts insurance coverage as applications soar during pandemic

Digitally transformed customer onboarding process saves thousands of work hours

Program intake is a crucial stage in the customer journey for health insurance exchanges operating under the Affordable Care Act (ACA), demanding accurate processing of thousands of documents each day. To accelerate customer onboarding and facilitate access to high-quality care, this state-run exchange uses Tungsten TotalAgility® to automate ACA eligibility adjudication processes from end to end. The new approach saves thousands of work hours annually and frees employees to focus on the most complex cases. It also helped the organization accommodate a sudden increase in workload during the pandemic.

8 MONTHS

From design to deployment

>70%

Automated processing achieved

25%

Of cases fully resolved in 24 hours

"The Tungsten TotalAgility Intelligent Automation platform has automated manual and redundant processes, allowing service center staff to focus on people and their needs, better addressing the human aspect of the Affordable Care Act."

About large health exchange

This large, state-run health exchange has a mandate to connect eligible residents with health insurance plans under the Affordable Care Act.

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