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You are here: Case Studies > Process Management Services for Third Party Administrator using Global Delivery Model
Process Management Services for Third Party Administrator using Global Delivery Model
ValueMomentum enables Third Party Administrator reduce costs, service-levels for Bills data entry, Claims entry
Industry
Insurance
Client
PIP, Workers' Compensation TPA (Subsidiary of leading BCBS organization)
Industry Needs addressed
Bill Entry, Claim Entry
- Our Client is a subsidiary of a leading BCBS organization providing Personal Injury Protection (PIP) and Workers' Compensation related Third Party Administration (TPA) services
- This Client sought to provide its Customers with rapid turnaround with bill adjudication and repricing services, while reducing the costs associated with providing these services
- In order to achieve both these objectives, our Client to outsource manually intensive processes pertaining to claims and bill entry for the thousands of bills received from its Customers each month. This strategy would enable the client on leveraging its expert staff and technology systems to focus on the knowledge intensive activities related to claims adjudication and repricing.
Service Delivered
Business Process Management (BPM)
- ValueMomentum assisted this Client by setting up an Offshore Dedicated Delivery Center (ODC) at its Offshore Development Center in Hyderabad, India.
- An initial “testing” was setup where ValueMomentum teams entered bill data for HCFA-1500 and UB-92 bills to determine viability of the outsourcing arrangement against pre-defined service benchmarks for quality and accuracy.
- Following this testing period, ValueMomentum developed a suite of applications that enabled the teams to download images, retrieve claims numbers associated with bills and enter bills using a “Double Entry” system to ensure high quality.
- Within days of parallel entry, the ODC teams were able to achieve an accuracy level of 99.9%, exceeding the Clients' expectations.
Benefits delivered
- The Client was able to significantly reduce costs associated with manual entry of bills
- The Client was also able to increase its service levels for its Customers, by setting the bar higher than previously achieved (99.9%) as well as a 24 hour turnaround time, thereby winning new accounts through this competitive advantage.
