Our client is a Third Party Administrator of self-insured health plans growing at over 100 percent annually and looking for cost
efficient capacity. The last thing they want to do is put those hard earned growth dollars into the same old, same old overhead buckets.
So, we started with claims entry and adjudication to see what we could do to keep them focused on sales and expansion efforts. |
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Goals
Like many engagements, we may start focused on a few
processes to get the comfort level up and show what we can
achieve. Our goal was a reduction in unitary cost per claim
of 7.5 percent. |
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Economics
We thought ahead on this one and priced the agreement at the
cost reduction goal from the start, which put the responsibility
on us to deliver at that price point, or we would not be profitable.
This guaranteed the delivery of the economic goal from day one, and
in return we were provided the freedom to aggressively process
improve on our end. |
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Metrics and Guaranteed Results
Given the unique structure of the pricing, the GMR was
delivered immediately, but we knew the prior SLA was 48 hours
from receipt of claims and that just wasn't good enough for us.
In addition to delivering on the financial side, we reduced the
average turn around time to 24 hours, and now we are looking
at other things to improve collaboratively. |
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