How BCBS NC drives business value with bots

“We are getting better and better in automation toolkits and we're really excited about the next generation of Pega Infinity because I think some of the tools to manage the robots and the dashboards are only going to get better.”

The Business Issue

As healthcare costs continue to rise, Blue Cross Blue Shield of North Carolina (BCBS NC) was seeking to drive value for the organization without rising premiums. Needing to scale while keeping costs low, the health insurer wanted to use tools to build capacity without having to hire additional employees. BCBS NC needed to build an enterprise-wide capability that would help increase efficiency for existing employees and drive bottom-line performance.

The Solution

To increase efficiency at scale while keeping costs low, BCBS NC implemented digital process automation, including robotics. Working with Pega and Cognizant, the health insurer adopted an agile approach to development. Cognizant specifically recommended the Rapid Application Development Model (RAD model) to help deliver results quickly. Working within the new development framework and to ensure customer-centricity, BCBS NC had to rework its strategy to be business driven and IT-enabled.

Within 140 days, the organization built its first-generation center of excellence (COE) to handle several processes (e.g. change management, risk management, workforce management, customer management). To remove and prevent future silos, the organization also built a governance framework as it built the COE. By implementing digital processes like natural language processing and machine learning processing, BCBS NC could uplift consumer experience and employee satisfaction.

The Results

• Implemented two bots in one quarter – now have 600 digital assistants and 14 robotic solutions
• Automated the release of funds process in Finance and saw a revenue uplift of more than $500,000
• Saved more than 500 hours of manual input on sending letters out to members
• Freed up employees to do more important and valuable work