Optimizing and standardizing data processes for more than 50 health insurance carriers
About Allcare
Allcare is one of Brazil's leading health plan distributors, operating in more than 20 states and partnered with 50 carriers. With over 600 health and dental plan options, Allcare manages more than 300,000 lives and works with 30,000 brokers nationwide, handling a high volume of monthly data from multiple sources.
Objective
With a large-scale operation involving multiple stakeholders and complex data from many sources, Allcare was looking for ways to consolidate information faster, reduce manual work and improve the accuracy of the more than 180 reconciliations it performs every month.
In addition, ANS Resolution RN 561 — issued by Brazil's private health insurance regulator and focused mainly on customer cancellations — requires pro-rata calculations, refunds and pass-through payments to carriers and brokerages to be reviewed on a regular basis.
The partnership with Dattos aimed to integrate processes, improve efficiency in records management and deliver the accuracy required to maintain the trust of clients and partners.
Challenges
Reduce dependence on spreadsheets
Drastically cut the time spent on manual reconciliations
Ensure contract compliance across multiple stakeholders, including members, companies or trade associations, and health insurance carriers.
Identify discrepancies and mitigate financial losses faster and more accurately
Ensure accurate payment of invoices to carriers and entities.
Ensure accurate receipt of commissions from carriers
The solution
Dattos implemented transactional reconciliation processes for more than 50 health insurance carriers, managing around 2,000 files per month across multiple formats.
The solution includes reconciling invoices, commissions and member records, standardizing and simplifying complex data management.
This automation enabled Allcare to make better use of its time and resources by eliminating extensive manual processes, reducing time spent on these activities, processing growing data volumes without expanding the team, and ensuring data accuracy across the different parties in the value chain.
Results
Significant improvement in data transformation and reconciliation
Process optimization, reducing the time spent on each reconciliation by 94%, from 3 hours to 10 minutes
Standardized processes for reconciling invoices, commissions and benefits across all carriers, increasing team efficiency
Greater accuracy and confidence in managed data
Our processes were highly manual and relied on Excel spreadsheets. We used to spend two or three hours on each reconciliation. Today, we complete it in ten minutes. My team works much more efficiently because we eliminated the manual work in Excel."
João Paulo
Financial Manager at Allcare
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“Our processes were highly manual and relied on Excel spreadsheets. We used to spend two or three hours on each reconciliation. Today, we complete it in ten minutes.”