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At a Glance

Challenge 

The mobile and innovation teams along with the CI&T team identified an opportunity to improve the process of medical reimbursement for one of the largest insurance companies in Brazil, which in many cases took up to 30 days.



Solution

CI&T has long been a partner in the development of the insurance company’s innovative solutions, CI&T has used its expertise in cognitive computing and through the use of Google API Vision has improved the image recognition of medical receipts, which was applied to  the SulAmérica’s health application created.



Results

Digital reimbursement has reduced the order analysis from days to hours and the use of the functionality is above all expectations. 

Digital Reimbursement: Quicker Document Analysis by Using Image Recognition and Machine Learning

Challenge

Anyone who has ever had to request a medical reimbursement from their insurance company knows very well how the process time-consuming and bureaucratic it is. This was no different for the 7 million customers of the second largest insurance company in Brazil.. Reimbursement payments are settled one of two ways: 1. Fill out a form on the insurance company’s website along with sending needed supporting documents via mail. 2. Go to the insurance company’s offices with documents in hand needed to file a request, which can take up to 30 days to reviews.
 
Technology has made it possible to implement digital transformation and simplification processes and streamlining improvements in the customer’s journey by using such tools as image and voice recognition, machine learning, artificial intelligence and big data.
 
The insurance company is known for understanding their customers’ needs. They created an innovation laboratory and recognized the opportunity to improve the way its users processed their reimbursements by digitizing and creating a more agile system.
 

Solution

For more than a decade, CI&T has been a partner of the insurance company, and together, they implemented the innovation lab. CI&T was tasked with coming up with a solution. for streamlining the medical reimbursement process. 
The CI&T team discovered that using Google Cloud Vision image recognition allowed for streamflow optimization and decided that this would be the best product to use for the project.

The digital reimbursement solution allowed for up to  R$1,000. The process started with the patient taking a photo of their medical receipt using their mobile phone and sends it to their insurer’s application. Using the image recognition technology, the document then goes through a validation process which analyzes repayment request patterns such as the amount of the reimbursement, the type of service provided and the record of the doctor who issued the receipt. The application also permits users to see the steps and process of their request until the refund has been issued.

This functionality developed by the CI&T team was incorporated into the insurance company’s services app for Android and iOS and was initially tested by its own employees. It was gradually implemented for the other users. The application has had about 1 million downloads, with 10 million transactions made by policyholders were made in the app in 2016. Beneficiaries of policies can also quickly access services such as accessing their virtual card, medical references network, information about medicine discounts and are able to ask questions through chat.
 

Results

With a more streamlined process of digitally capturing reimbursement information and documents, the review time for repayment has been cut significantly. What used to take days can now be sorted through in a matter of hours.

The number of users who have been using the functionality has been more than expected.

“The company continually invests in technological innovation to enhance the customer experience. As a result of this strategy, the digital reimbursement is a pioneering facility in the supplementary health market that will provide even more agility and comfort for the insured, " says the  Vice President of Health and Dental.