AXA

Company background

AXA Thailand faced inefficiencies in managing group and individual health claims due to its reliance on a Third-Party Administrator (TPA) model. The existing system struggled to streamline claims processing, provider network management, billing, and reporting, leading to delays, increased costs, and less-than-ideal customer experiences. Manual processes created a backlog of claims, impacting both staff efficiency and overall business performance. 

To address these challenges, AXA sought a modern, scalable solution that could be seamlessly integrated within its ecosystem – enhancing operational efficiency while laying the foundation for future improvements.

AXA has adopted CoverGo’s claims platform, integrating it within their existing ecosystem to replace the traditional TPA model with an in-house, SaaS-based approach. This transformation enables AXA to process claims digitally, improving efficiency, reducing reliance on third parties, and streamlining operations.

The solution included:

• Claims processing and management – A streamlined process for efficient and accurate claims handling, reducing processing time and errors.
• Provider network and agreement management – A robust system for managing provider networks and agreements, ensuring seamless integration with AXA’s operations.
• Billing and collection – Automated tools that simplify billing and collections, improving transparency and accuracy.
• Advanced reporting – Customizable reporting tools that deliver actionable insights and enhance decision-making.
• Digital provider and claims portal – Hospitals can seamlessly access member information, policy details, and benefit quotas, as well as create and submit claims effortlessly. Meanwhile, AXA claims staff can process claims digitally – including individual and batch creation, settlement, investigation, alert creation, tracking, and document management – while automating key workflows to enhance efficiency.

Beyond claims management, the CoverGo platform lays the foundation for future advancements in AXA’s health ecosystem by offering end-to-end capabilities, from product building and distribution to policy administration. This comprehensive digital transformation has empowered AXA to improve operational efficiency, enhance provider relationships, and set the stage for continued innovation in healthcare insurance.

By implementing CoverGo’s next-generation claims management solution, AXA Thailand achieved a comprehensive transformation of its claims operations. The digital, data-driven platform empowered AXA to significantly reduce operational costs, enhance fraud detection, and unlock new revenue opportunities — all while providing employees with intuitive tools to streamline their workflows and improve service delivery.

The result is a fully paperless, automated claims ecosystem that delivers faster, more transparent experiences for both staff and customers, setting a new standard for operational excellence and customer satisfaction in the region.

For AXA’s business

• Up to 80% cost savings on claims operations, based on similar projects in the region.
• Reduction in fraud and abuse through enhanced data capture, analysis, and logic-driven adjudication.
• Increased sales opportunities via up/cross-selling features integrated within the member portal.
• Greater oversight of processes and data, enabling smarter business strategy development.

For AXA employees

• User-friendly digital portals enabling seamless claims handling and automation for simple cases.
• Reduced claims backlog, allowing staff to focus on investigations rather than administrative tasks.
• Integrated document management, eliminating the need for email-based submissions and large attachments.
• Paperless and automated workflows, reducing manual processes and improving compliance.
• Fewer human errors and compliance issues, increasing operational accuracy.
• Improved employee experience, leading to lower staff turnover.

For AXA clients

• Seamless digital claims submission by clients or providers via dedicated portals, eliminating paper forms and emails.
• Instant or fast-tracked claims adjudication, with complex cases processed in just a few days.
• Automated payment processing, significantly reducing delays.
• A streamlined and transparent claims experience, leading to improved customer satisfaction.

By leveraging CoverGo’s innovative technology and deep industry expertise, AXA Thailand has successfully modernized its claims management system, ensuring greater efficiency, enhanced stakeholder experiences, and a strong foundation for future growth.