RP Sanjiv Goenka Group

Generate greater value through process mining in healthcare

Root out hidden process inefficiencies to reduce
costs and improve experiences

Reveal hidden process efficiencies for fast and effective solutions

Process mining is like an MRI for your claims administration processes. It uses actual event data to identify the disconnects, bottlenecks, delays, manual activities, and hand-offs that create friction, hurt member experience, increase operating costs, and open your organization to regulatory fines.

With solutions based on real world data, not perceptions or anecdotes, your organization can increase auto-adjudication rates, improve financial and benefits accuracy and streamline cycle time. Those add up to millions of dollars saved and more satisfied providers and members.

Process mining for healthcare

We combine data from core administration and other key systems into a single comprehensive data model that enables us to visualize and trace the entire life cycle of a transaction. We literally show the friction points throughout a process and their root causes so you can make effective corrections.

Execution Management System (EMS)

EMS apps enable your operating teams to prioritize the daily activities with the biggest impact on business outcomes while avoiding information overload.

Proactive insights, prioritized tasks—such as directing complex high value claims to the most experienced service representatives—and next-best action recommendations help ensure optimal efficiency. Leverage the power of EMS apps and AI workbench to benefit all levels of your organization.

Digital twin

Create a digitized replica of your actual healthcare processes so you can test your ideas before implementing them. Predict consequences of process changes with 100% objectivity.

Digital twin enables you to simulate process changes and evaluate their impact before making a real-world change. Simulate the impact of improving claims auto-adjudication; fluctuating volumes; accuracy enhancements; new IT releases; new business rules configurations, then make the changes that will have the greatest impact.

Outcomes delivered


Identify millions in annual savings


Achieve up to 20% reduction in adjustments rate


Enable fully automated no-touch processes


Reduce provider mismatches

Related Insights

What you don’t know about your operations workflows is likely hurting your business. Process mining in healthcare reveals the friction due to workarounds, manual activities, dead ends, handoffs, and disconnects that cost time and money – and points the way toward truly effective solutions for delivering improved experiences at lower costs.

In today’s experience economy, customer experience (CX) is the biggest differentiator. The payoffs for delivering a great experience are tangible – from customer willingness to pay a premium to increased loyalty. For businesses, every experience offers an opportunity to create value – for customers as well as the organization.

The AI-First Health Plan: Leveraging cutting-edge technology to revolutionize healthcare, improve patient outcomes, and streamline administrative processes

This guide is about kicking off discussions and fresh CX thinking among your peers from various departments. This is central to the success of your initiative for two reasons.

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Eddie Monteiro

Eddie is currently Chief Operating Officer at Educational Testing Service (ETS), where he sets and drives the transformation agenda across the company and has responsibility for all technology and operations functions in addition to the College Board, K-12, and teacher licensure businesses. He previously ran business and technology services at Pearson, where he built a global team to enable scalable delivery of enterprise functions. Prior to that, while at IBM, he held several executive leadership roles in the US, Mexico and Brazil across a diverse set of industries and clients.
Geetha Krishnan

Geetha Krishnan

Geetha Krishnan consults with the Indian Institute for Human Settlements in Bangalore as Senior Advisor and Head of Digital Blended Learning, where he spearheads their online learning and continuing education portfolio. Over 25 years, Geetha has played senior roles in diverse sectors such as academia, online learning, and advertising. In his last role as Director – Centre for Executive Education at the Indian School of Business (ISB), Geetha was head of the profit center comprising more than 50 open enrollment and long duration programs and spearheaded ISB’s foray into online learning by enabling their partnership with Coursera.
Susan Aldridge

Susan Aldridge

Dr. Aldridge is an Executive Higher Education Consultant to university presidents and ministers of education regarding business models and technology-enhanced education. She recently retired from Drexel University after serving six years as president of Drexel University Online overseeing more than 125 online programs. During her six-year tenure as President of University of Maryland Global Campus (UMGC), she doubled the university’s enrollment to 97,000 – to become the largest public American university. She also served as Vice Chancellor for Troy University’s Global Campus managing online programs and satellite campuses in 12 countries and 17 states.

Alan Greenberg

Alan Greenberg

Previously Director Apple Education EMEA and APAC, Alan led the team that built Education Podcasting and iTunes U. He has worked on the development of Apple Education mobile strategy, iOS Education APPs, and developed the SEED CSR project in China, a collaboration between Apple, Foxconn, and Pearson. Executive Board of WideCells Group Plc, Group CBDO, and EVP & Founder of Wideacademy; his working contributions include multiple technology engagements providing domain expertise across digital, mobile, brand, scale-up, international business development, and venture capital.

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