With the rising number of insured individuals comes a torrent of eligibility determinations and claims, as well as new regulations that govern them. Providing a consistent, high-quality service is key to increased member loyalty, satisfaction, and ultimately growth and revenues.
Firstsource provides the best-practice workflows, technology, expertise and support healthcare payers’ need to keep up with ongoing operational and administrative demands, and deliver an unmatched customer experience.
We combine world-class personal support with highly trained, industry-knowledgeable professionals and leading-edge technology to deliver a comprehensive set of proven services and solutions for healthcare payers.
One of America’s leading non-profit integrated health plan providers needed help to improve recording of Social Security Numbers (SSN) and Taxpayer Identification Numbers (TIN) information of its members, to comply with the provisions of the Affordable Care Act.
Firstsource developed an automated system called Sympraxis to enter the missing data efficiently. The process reduced time for entering the missing data and the room for errors. Once converted to the Sympraxis system for input, data entries increased significantly to an average of 5000 entries per day. The system eliminated operational inefficiencies and delivered results in quick time.
A customized front end portal assisted in efficient data entry directly into the client database. Through the creation of this portal, Firstsource was able to deliver 60,000 files in 12 business days, ahead of schedule. This allowed for an early start on phase 2 which included 25,000+ entries completed in 7 days. All project deadlines were met in record time and Firstsource delivery exceeded client expectations.
One of the largest health insurance carriers in the US identified a 250% growth potential in business between 2013 and 2015 as a result of the Affordable Care Act (ACA), which stipulated a combined out-of pocket limit in 2014 for medical and drug costs.
The out-of-pocket limit is calculated and reconciled by a Firstsource reconciliation team. Multiple sources increase the complexity since the entire process is manual, giving room for errors. Firstsource implemented automation to avoid multiple screen navigation and automate excess and Out-of-Pocket (OOP) calculation, bringing down the transaction processing time by 25%.
Firstsource helped in bringing cost savings through productivity gains and improving the accuracy of the entire process. The client witnessed a 27% productivity improvement leading to a $1.2mn cost saving across 3 years with additional potential of over $2mn savings via replication. Turn-around time dropped from 5 days to 2 days resulting in 250% increase in productivity.
This prestigious designation is granted only to the best and most disruptive BPO companies
We believe in long term partnerships - over half of our clients have been with us for 7 years or longer
We deliver 24/7 customer support aided by advanced analytics, RPA and cutting-edge technology