How AXA Mansard fully standardized their tariffs; digitizing their Claims Processing
Use Case for top African Health Insurer
AXA Mansard Health Limited is a major leader in Africa – a leading provider of Life and Non-Life insurance products and services, with a thriving presence in Nigeria. They are the Health Maintenance Organization (HMO) arm of the AXA Mansard group of companies employing over 200 employees and serving more than 250,000 customers. The company has deployed state-of-the-art technology to attain operational excellence while contributing to prompt service delivery and overcoming challenges being encountered in the Nigerian health insurance industry.
Challenge: Claims Processing x Tariff Management
A big challenge to effectively automating claims processing for African Health Insurers is tariff management. Tariffs are the price list for medical consumables and services agreed between a health insurer and their healthcare providers. Health insurers work with hundreds or thousands of Providers which means different tariff prices and different tariff formats. Getting a standardized format (names of consumables and services) is a herculean challenge, especially when approached in a non-technology backed way.
Solution: Curacel Claims x Tariffs
Thanks to Curacel and her technology, AXA Mansard has been able to standardize the tariff for all 1,700 of her Providers. This is the true first step in achieving a high degree of automation with claims processing – collection, adjudication, reconciliation and payments. We anticipate up to 25% cost savings from curbing Fraud, Waste & Abuse (FWA), 75% claims turnaround time among other benefits.
“We had attempted to standardise our tariffs internally for years without much success. When Curacel approached us with their Claims and Fraud Detection backed by AI, we decided to give them the standardization project and they have massively delivered. Our journey towards fast and efficient claims processing has just begun.” – Dr. Omolola Odedere, Head, Fraud, Waste & Abuse, AXA Mansard Health.
Curacel is an insurtech company, building solutions that enable insurance companies to effectively and efficiently process claims faster, detect fraud early and for better insurance distribution.