Simplified invoice control: CONCORDIA

The knowledge that all companies from all industries benefit from digitalization is profound and firmly rooted in the world of technology development. In this context, CONCORDIA, a Swiss health insurance company, introduced a new process of invoice verification a few years ago: digital invoice control. It pursues the goal of saving costs and time, which benefit its customers, in a time of rising healthcare costs.

CONCORDIA continues its digitalization journey in collaboration with Netcetera. One of their latest projects is the expansion of digital billing control. CONCORDIA involves its customers directly and digitally in the control of the billing of services, according to the motto "Some errors can only be discovered by the insured themselves". CONCORDIA contacts its policyholders via the customer portal myCONCORDIA or the myCONCORDIA app when invoices show ambiguities or anomalies.

A customer of CONCORDIA receives a package of medication for high blood pressure after a visit to the family doctor. The doctor takes care of the invoice and sends it digitally to CONCORDIA.

At CONCORDIA, all incoming invoices are carefully checked. As soon as an invoice shows any abnormality, it gets sorted out by the system. This is also the case with this customer's invoice. CONCORDIA informs the customer immediately via SMS or e-mail. They can then easily check the bill on myCONCORDIA (app and customer portal). There, the customer answers questions that help clarify the matter: The bill states that the customer received eleven packs of medication for high blood pressure. Is that correct? With just a few clicks, the customer corrects: received only one package. Then the customer leaves the rest to CONCORDIA. With the digital control of service invoices, CONCORDIA saves its policyholders several hundred million Swiss francs per year. With the new add-on and the participation of its policyholders, CONCORDIA is pursuing the goal of further increasing efficiency and saving costs, resources, and time.

As part of the digital invoice verification extension project, Netcetera developed the backend system of this add-on. Invoices that show anomalies, as mentioned above, and get removed from the invoice verification process, are further processed by this system.

It actively involves the customer in the invoice verification process.

First, the application evaluates the invoice type. Among other things, it checks whether there are questions that match the analyzed anomaly, whether customers use myCONCORDIA, or how they can be contacted. The message to the insured is then sent via SMS or e-mail. With predefined question-and-answer templates, the application makes it easier for customers to check their service invoices. In addition, they have the option of entering the corrected answer in a free text field.

After receiving the customer's response via the app, the system allows the invoice to flow back into the invoice control process. There, further processing steps are triggered. This also happens based on predefined conditions and rules.

The implementation phase – from planning and conception to development and go-live – took nine months. During this time, the teams of Netcetera and CONCORDIA developed this completely new solution in close cooperation.

"Successfully, our teams used an agile approach to develop the clearly defined project scope during a given timeframe," says Ulrich Tanner, Head of Rates & Benefits Management. "They skillfully used different tools and successfully integrated the new backend system into CONCORDIA's complex system landscape." In addition to the technological know-how, however, good cooperation between the two teams was also crucial for the success of the project and the timely (market) introduction and go-live.

The new add-on brings together two essential elements of today's service billing audit: Digitization and Customer.

Significant advantages of the system are:

• It increases the quality of invoice control because of first-hand answers from the people concerned.
• The digital extension further reduces costs, both administrative and those that would be generated by errors.
• The increased level of automation also increases the processing speed of invoices.

About CONCORDIA

CONCORDIA is one of the largest Swiss health insurers and the market leader in the Principality of Liechtenstein. It currently has 628,000 basic insurance policyholders. CONCORDIA is organized under the umbrella of a non-profit association. For CONCORDIA, the focus is on first-class personal service, whether on-site in the approximately 190 agencies and branch offices, or in contact via digital media.