The client is a renowned California-based medical billing company specializing in managing claims, payment and billing.
The client received thousands of healthcare benefit claim forms and related documents on a daily basis. Due to complexity of forms, disparity of document types, and tedious processes, the client found it difficult to manage the inflow of work. This resulted in a growing backlog of claims. As the client’s relationship with its customers was at stake, it was looking for a service provider, who could help them clear the backlog and provide a scalable, flexible and standardized solution for their future needs.
Prior to this, we had optimized speed claim processing with the help of dedicated teams. So, we chose expert claims processors, claims audit experts, claims adjustment analysts etc. from our organization to handle this requirement. The team thoroughly investigated how to improve its reimbursement process and capture claims documents efficiently and accurately. Basis the investigation, the team designed a comprehensive phase-by-phase transition approach to clear the backlogs. This included creation of a more efficient document management system and implementation of an automated system to quickly capture multi-page claim forms. The system received claims electronically, reduced manual data entry and errors and even automated the claims adjudication process.
Our customized solution, helped the client clear backlogs at a speed three times faster than the original pace. The benefits of our solution included: