Fullerton Health is a leading corporate healthcare provider in Asia. With over 520 medical centres serving over 17,000 corporate clients across 9 markets, Fullerton Health is committed to delivering exceptional care to clients.
Customer Story
Redefining Efficiency in Healthcare: Fullerton Health's Journey to Same-Day Claims Processing & 87% Faster Finance Reconciliation
We don’t position Workato as an IT solution; it’s a tool that helps our whole company be more efficient & effective. The results speak for themselves and our users can be part of the game as well, innovating as citizen developers.
Challenges
- Laborious claims processing
- Errors hurt customer experience
- Stringent compliance requirements
Fullerton Health manages highly complex billing processes between clinics and various payers in the healthcare system, including self-payment, insurers, government, and employers. This repetitive, labour-intensive and rule-based process, involving close to 2 million claims a year), posed challenges in terms of customer service, human errors, compliance, and efficiency.
For instance, to provide patients a seamless experience for panel clinic visits, clinics need to submit claims into a portal where it gets processed and adjudicated (to comply with corporate or insurance policy) before it gets passed back to the company or insurer so that the billing process can start.
With such a high volume of transactions to process, the manual workload involved was overwhelming the claims team and affected service delivery.
In the same way, Fullerton Health’s finance team was grappling with a very tedious finance reconciliation process - an annual effort that was taking too long because of the complexity involved in importing data into the Enterprise Resource Planning (ERP) system.
A future-ready automation strategy became core to solving these challenges.
Solution
- Automate end-to-end billing
- Sync real-time data securely
- Foster agility and innovation
The Fullerton Health IT organization chose Workato because the low/no-code platform proved to be far easier to build with and maintain than the incumbent.
This enabled the business to adopt Workato wall-to-wall across Fullerton Health’s IT, Finance, Operations, and HR teams.
Impact
- Accurate same-day claims processing, even at peak load.
- 200 man hours saved monthly, with system slowdowns eliminated.
- >37% cost reduction with a 90% automated claims assessment process
- 87% faster finance reconciliation
Fullerton Health collaborated with Workato, leveraging enterprise automation to identify invalid claims and auto-return them back to service providers. These automations also integrate between multiple systems to provide service providers with additional comments on what is wrong with the claim and why it is being returned, so as to reduce unnecessary to and fro.
Coupled with an end-to-end automation of the billing process, the integrated system significantly reduced error rates, ensuring a faster and more accurate claims assessment. This not only improved customer service by eliminating human errors but also enhanced compliance in the highly regulated healthcare and finance space.
The automated system yielded remarkable results, including a dramatic drop in error rates, 200 man hours of time savings a month, and a substantial 37% reduction in claims processing cost. This system now also guarantees same day processing of claims, even at peak load.
With Workato, the finance reconciliation process is also 87% faster. They are now able to accurately close the books every month, instead of just once annually.
Staff, initially skeptical, now actively advocate for further automation, showcasing the transformative impact on their daily workflows.
What’s Next?
As Fullerton Health continues to innovate with Workato, its commitment to a patient-centric approach and data-driven automation will reshape the landscape of healthcare administration in Asia and beyond.