Traditional claims processing often puts the burden on end users with extensive forms and documentation in addition to administrative time to verify and process claims. ITA Group wanted to help its users ease participation by shifting that burden from a human-driven workflow to an automated one powered by AI and machine learning.
To eliminate manual entry and human intervention to verify claims, ITA Group recognized the need to accelerate processing speed for current users. It also knew the solution needed to remain flexible and scalable to support their growing customer base and the volume of transactions.
“We wanted to design and implement a fully cloud-based solution that removed the hurdles for end users,” shared ITA Group Product Owner Chris Grunwald. Like many companies, ITA Group could benefit from greater bandwidth and sought a partner to get them across the finish line. After vetting other firms, they selected Trility Consulting.
“Our need was more than just hiring extra bandwidth,” shared Steve Billingsley, Director of Enterprise Architecture. “Trility had the specialization for the project, and at the same time could further our cloud initiative as we steadily move more resources to the cloud.”
From start to finish, it was an absolute pleasure working with the Trility team. The team collaborated with us, truly understood our business needs, and designed and implemented a solution for a tough problem to solve.
Part of Trility’s continuous delivery approach is to understand all the business requirements and desired attributes for the solution and how they intertwine and impact existing environments and ongoing initiatives. Using this method and collaborating with stakeholders, the team mapped out a plan to address key hurdles.
To ensure no disruption to existing users, the Trility team devised parallel production environments that worked simultaneously. When all the claims were closed for one of the production environments, it was deprecated, ensuring users were seamlessly transitioned to the new environment.
ITA Group knew end users required customization, so delivering a flexible and scalable product was critical.
“We're never going to see products and invoices come in a consistent way, so we needed a system to learn what these products look like and automatically assign identifiers to process them,” Grunwald shared. “We wanted to design this so we weren't locked into a specific flow but could always provide the same outcome – a participant could upload an invoice or receipt and be done.”
Collaborating with ITA Group, the Trility team devised a modular solution. “The workflow is not rigid at all. We’re able to take different components and adjust the order based on our customer’s needs,” said Grunwald. The solution scrapes information from invoice images to identify and confirm product-specific items to verify eligibility. This solution makes it effortless for participants and reduces claims-processing cost for ITA Group clients.
The solution also helps ITA Group clients avoid overpayments and fraud attempts by validating claim submissions with custom mitigation rules built on machine learning. The customization allows each client to determine when and how human intervention is necessary, significantly lowering the administrative burden.
Setting up an end-to-end CI/CD pipeline from Day 1 is a best practice for Trility, making it easy to iterate and deploy at a higher frequency from the start. For this project, the value was demonstrated early in the testing phase to validate machine-learning results. The CI/CD pipelines allowed for a higher frequency of iterative testing as they automated the verification of claims by extracting and matching data from invoices or receipts to eligible products.
Long term, the CI/CD framework also allows ITA Group to easily switch out algorithms and tools based on client needs.
According to Billingsley, the Trility team brought unexpected value that was not common when hiring other consultants.
Trility brought a tremendous amount of best practices and techniques to the table, like iterative approaches to deployment and development that have enabled other teams and environments that weren’t necessarily related to this project.
In addition, Trility collected data and provided comparison reports between the machine-learning results and the manual ones before moving the solution to production. The reporting capability is ongoing and allows ITA Group to monitor, track, and demonstrate improvements and return on investment.
“From start to finish, it was an absolute pleasure working with the Trility team. The team collaborated with us, truly understood our business needs, and designed and implemented a solution for a tough problem to solve,” Grunwald said.
Both Grunwald and Adam DePauw, Enterprise Architect, appreciated the overall collaboration with the team from Trility. Sharing the frequent progress and status reports, recommendations for future enhancements, and documentation for internal teams was valuable in meeting the deadline and future enhancements. By including them in stand-ups and bi-weekly demos, ITA Group and Trility were able to manage change, validate work and expedite delivering the finished product.
It was a pleasant surprise to find a highly skilled technical team who are also excellent communicators. Trility is one of the best consulting firms I’ve worked with.
ITA Group, with help from Trility, improved the claims management solution by operationalizing the software using machine-learning algorithms with CI/CD pipelines for data extraction and matching that resulted in:
“We simplified the processing so participants no longer need to spend 5–10 minutes per claim. Now, they can simply upload a receipt or invoice – what equates to hours of work if you were a top performer,” said Grunwald.
“Working with Trility has provided us with best practices for building and releasing pipelines and templates,” shared DePauw. Those learnings have helped ITA Group on other projects as it continues to modernize and leverage public cloud services.
The AI-powered enhancements were launched shortly after ITA Group was named a Strong Performer in Channel Incentive Management (CIM) by Forrester. By building the Channel Sales Claim Management solution with distinct, customizable components to meet the needs of existing and future partners, ITA Group continues to solidify its position as a global channel incentive solution provider.
ITA Group delivers custom-crafted global engagement solutions that motivate and inspire employees, channel partners and customers. With operations globally and throughout the U.S., ITA Group designs unique business strategies and experiences that create connections, motivate audiences and drive purposeful change for some of the world's biggest brands. Find out more at www.itagroup.com.