Case Study: a large West Coast health plan cuts enrollment costs and speeds approvals with Conduent enrollment automation

Large West Coast Health Plan cuts enrollment approval time to under 60 seconds with Conduent

The large west coast health plan faced significant challenges in processing a high volume of enrollment applications manually, leading to inconsistent criteria application, delays of up to two weeks, and increased risk of accepting undue costs. To address this, they partnered with Conduent to implement an automated enrollment solution to improve speed, accuracy, and consistency while scaling for open and special enrollment periods.

Conduent implemented a rules-based enrollment system that automated application decisions in under one minute by verifying information against established criteria and third-party data sources. This solution processed over 27,000 applications in 2021, reducing approval times from over 7 days to under 60 seconds while achieving over 99.5% accuracy. The results included over $1 million in annual enrollment cost savings and helping the plan avoid an estimated $7,000 in monthly claims expense from unqualified members.