The Provider has more than 700,000 members with health, life, and dental coverage. The depth and breadth of care offered means more than one million document pages are received every month including 650,000 multi-page claim documents. Its 2000 employees are tasked with processing 12,000 claims a day.
Slow response times
Laden with manual tasks
The Insurer’s employees were buried in a mountain of paperwork and chained to an inefficient system calling for the necessity of low-value manual tasks, which slowed response time to customer inquiries, increased costs and created hassles at every turn. A new administrative system helped improve the situation, but it still had functionality gaps that did not solve all the issues this client faced. Leading them to IPD for an operational transformation.
Solve 95% of member inquiries on the first contact
Meet an average 5-day turnaround time for claims processing Record a 99.5% accuracy in claims payments
To stay competitive and retain valuable customers, the Insurer implemented a process and content management solution from IPD. IPD’s powerful solution enabled the client to meet its service and productivity goals and provided substantial savings over the existing environment.
Efficiencies created by workflow optimization gave the Insurer a competitive advantage over other health insurers. An initial implementation for 500 users focused on the areas of Claims and Customer Service. IPD’s software Delivers process automation and control, fast access to information and tightly integrated applications. Now claims are accurately paid in days instead of weeks, and information flows smoothly and quickly enterprise-wide.
"I think IPD’s solution offers a lot in the way of multi-tasking. It’s more than just imaging a document or routing a claim from one desk to another. It’s the ability of the system to apply multiple commands when a claim is completed," says the Director of Claims. "When the processor hits thumbs up, a number of things happen that before might have taken ten additional steps."
The Insurer needs the agility to add new users easily and quickly. The agile IPD solution allows for the rapid addition of new users and supports the ongoing addition of new types of work based on configured distribution rules. In addition to IPD’s transforming claims and customer service, the client contracted IPD to implement a general process management solution enterprise-wide. Now Enrollment, Accounts Receivable and all incoming documents benefit from IPD’s robust solution.
The projected direct cost savings for the project are in the millions of dollars and the benefits to the customer are immeasurable. Cost-effective systems, superior service and best-in-breed technology have transformed the Insurer’s capabilities and operations, ensuring its position as a leading provider of health insurance.