Case Study: Scott & White Health Plan achieves 75% faster network setup and cuts pay-class setup from 45 to 5 minutes with Nintex Foxtrot RPA

Health Management organization sees 75% reduction in time to establish new networks

Scott & White Health Plan and Insurance Company (SWHP) is a Texas-based HMO with more than 215,000 members and part of Baylor Scott & White Health. SWHP faced heavy manual data work—copying and pasting rates, services and pricing—particularly around ACA-related tasks. Creating new provider networks could take up to four weeks and pay-class setup consumed as much as 45 minutes per job, driving inefficiency and higher costs.

By deploying Nintex Foxtrot RPA to operate in the application UI like a virtual employee, SWHP automated provider network creation, pay-class setup, claims reprocessing for retroactive pricing changes, and other manual processes. Outcomes included a 75% reduction in new-network setup time (to about one week), pay-class setup cut from 45 minutes to five, automated claim credits/checks, improved accuracy, and the ability to scale operations with a small team.

Scott & White Health Plan

Chris Gengo

Director of Operations Systems