Case Study: a large U.S. health insurer achieves faster fraud investigations and $2 million in annual savings with EXL

Human ingenuity in action: Self-service investigation capabilities saves millions

EXL worked with a large U.S. health insurer that needed to improve how its fraud and abuse investigators produced trend reports. The existing process was highly manual, requiring staff to pull data from multiple sources, identify outliers, and hand off reports, which took up to 48 hours for four full-time employees to complete 250 reports.

EXL implemented a self-service reporting capability using an interactive visualization tool and a parameterized view that automatically summarized claims, members, providers, and dates. This made the reports 100% self-sufficient with no manual data exports or loads, helped redeploy four full-time employees, delivered $250,000 in immediate savings, and is expected to save the client about $2 million annually by enabling faster fraud investigation across more providers.