Case Study: Medical Insurance Company achieves faster, more accurate claims processing with Rocket Software

Rocket® Process Automation Brings RPA to IBM® i/zSystems Automating IBM i/zSystems processes drives millions of dollars in savings

Medical Insurance Company needed to improve claims processing on its IBM i/zSystems core systems, where manual claims were being kicked out of automation for simple issues like provider data mismatches or pricing discrepancies. These exceptions slowed payments, increased errors and compliance risk, and drove up costs, while internal development approaches were too slow to keep up with changing claims rules.

Rocket Software implemented Rocket Process Automation to use RPA robots that connect directly to legacy mainframe applications, triage correctable errors, fix them, and resubmit claims automatically. The result was a rise in auto-adjudication rates from 82% to 94%, a reduction of about 120,000 manual claims per year, and roughly $12M in savings, with the solution paying for itself quickly.