Claims Processing: Vast Efficiency and Cost Improvements
For more than 40 years, this company has provided document management and financial transaction automation to its clients. It is now a global leader in business process outsourcing (BPO).
The company’s customer, a Fortune 100 healthcare claims processing company, was experiencing inconsistencies in exceptions processing and charts recycling that had led to lagging service metrics and a decrease in service quality.
The BPO firm approached Aptara in need of a partner with a proven track record managing healthcare regulatory compliance who could help them help their customer.
They asked Aptara to:
- Accurately process over 1 million Medicare claims per month
- Meet pre-defined service-level agreements (SLAs) within 18 weeks
- Significantly decrease turnaround times
Aptara developed a cost-effective workflow solution that includes monitoring systems and tiered skill-level service provision.
Aptara hired employees for the processing center, got them up to speed via web-based training, and built an IT infrastructure. Real-time monitoring and reporting ensured that the staffing level could handle the volume of work successfully.
The improved workflow saved money and increased shareholder value. In addition, Aptara:
- Reduced turnaround times by 12-hours
- Exceeded SLA quality benchmarks
- Reduced recycled claims significantly via real-time exceptions processing monitoring
- Significant cost savings