Patient onboarding · Production

Appian member enrollment, onboarding and maintenance automation for health plans

The problem

Health plans face manual processing burdens during member enrollment and onboarding, making it difficult to guarantee accuracy amid constant member data changes and to deliver a seamless member experience.

Workflow diagram · grounded in source
1
Member enrollment initiated
trigger
“your health plan's first interaction with them will leave a lasting impression, so you want to make it a good one”
2
Intelligent automation replaces manual processing
ai_action
“eliminate manual processing and discover how intelligent automation makes onboarding and maintaining members run smoother”
3
Real-time member data updates
integration
“Guarantee accuracy during perpetual member data changes with real-time updates”
4
Member statistics visibility output
output
“Gain clear and accurate visibility into member statistics to achieve a seamless customer experience”
5
Utilization management automation
ai_action
“Automate your utilization management on a fast and powerful low-code platform”
Reported outcome

Appian's intelligent automation enables seamless member onboarding and maintenance, with real-time data accuracy, clear visibility into member statistics, lower administrative costs, and automated utilization management.

Reported metrics
Member onboarding experienceeasy and seamless
Administrative Loss Ratio and administrative costsLower payer Administrative Loss Ratio and all administrative costs
Reported stack
Appian
Source
https://appian.com/industries/healthcare/provider-member-network-services/member-enrollment-onboarding-maintenance
Read source ↗

Frequently asked questions

What did this team achieve with this AI workflow?

Appian's intelligent automation enables seamless member onboarding and maintenance, with real-time data accuracy, clear visibility into member statistics, lower administrative costs, and automated utilization management.

What tools did this team use?

Appian.

What results were reported?

Member onboarding experience: easy and seamless; Administrative Loss Ratio and administrative costs: Lower payer Administrative Loss Ratio and all administrative costs (source-reported, not independently verified).

How is this patient onboarding AI workflow structured?

Member enrollment initiated → Intelligent automation replaces manual processing → Real-time member data updates → Member statistics visibility output → Utilization management automation.

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