Stay ahead with cost savings: a top US healthcare insurance provider experiences $100K reduction in costs

$100K
Reduction in costs
$500k
cost reduction anticipated over the next 6 months
Stay ahead with cost savings: a top US healthcare insurance provider experiences $100K reduction in costs
Case study

Background

The client is a leading healthcare insurance provider based out of the United States with a workforce of over 285,000 professionals and a presence in more than 130 countries. As a diversified healthcare organization, the client aims at creating a health care system that is connected, aligned and more affordable for all stakeholders. It also partners with care providers, collaborating in new ways to improve patient care.

Optimising mailroom operations had become a major priority for the client with the rapidly growing number of documents received by its mailrooms. The large volumes were inhibiting timely and accurate processing of documents resulting in an adverse impact on costs.

Business challenge

  • The client’s mailrooms received over 1 million documents monthly of which just 6% were digitally filed while the remaining 94% were physical copies. These documents required scanning and manual checking for categorisation in accordance with pre-defined specifications.
  • A sizeable chunk of these documents such as appeal claims were time-critical and required closure within a prescribed time window. Human error on account of manual checking gave rise to misclassification and reporting delays. The consequent delay in processing of such time-sensitive documents led to penalty charges by regulatory authorities, increased costs and had a negative impact on customer experience.
  • The client approached Firstsource for a solution that could achieve accurate document identification without manual review. Additionally, it also required correct identification of all appeal documents with zero false-negatives to ensure timely reporting of every single time sensitive document.

Firstsource solution

Addressing machine related challenges in the traditional approach

  • The traditional approach involved manually identifying documents and keywords. Once identified, these features then formed the basis for manual classification into respective document groups. Deploying machines to replace this manual sorting has been challenging as machines have traditionally not been adept at this form of classification due to the complexity of sorting rules.
  • This hurdle was successfully tackled through incorporation of an innovative and specialized technique to identify crucial features. These features were then fed into the statistical modeling framework to arrive at higher accuracy.

Incorporating the best techniques for identification and extraction

  • Additionally, the solution incorporated barcode/logo identification using image processing techniques.
  • Keyword extraction processes were based on fuzzy logic matching and used natural language processing techniques.
  • Lastly, the solution framework was integrated within the workflow application for seamless implementation.

Business impact

The solution resulted in immediate tangible cost reductions. In addition to sizeable cost reductions, the client also enjoyed benefits of improved customer experience and fewer penalty charges.

$100k reduction in costs

$500k cost reduction anticipated over the next 6 months.

$100K
Reduction in costs
$500k
cost reduction anticipated over the next 6 months

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Firstsource is a leading provider of customised Business Process Management (BPM) services. We specialise in helping clients stay ahead of the curve through transformational solutions in order to reimagine business processes and deliver increased efficiency, deeper insights and superior outcomes.

We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines and India. Our ‘rightshore’ delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals.

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