noun_Email_707352 noun_917542_cc Map point Play Untitled Retweet Group 3 Fill 1

Back office automation for a leading Healthcare Solution

Focused on the business imperatives and workflow based on consolidated requests.

Our team

EVRY India

The client is a leading healthcare product company, specialized in Care Management, Pre-authorization, Population health and ACO. Their portfolio consists of multiple products that are sold in modules or packaged solutions. As a key partner with the nation’s leading health plan and risk bearing provider, it assists the provider to optimize personalized delivery of predictive and prescriptive decision support for clinicians, physicians, consumers and caregivers.

Customer Challenge

The company offers services in managing registration & enrollment of health plans to health providers or their clients. Registration and enrollment workflow supported by the customer’s team varied for each end-user clients. The support team managed enrollment requests of large data volumes received by multiple channels such as Fax, Jira tickets, phone calls and claim information files. The current workflow managed by end providers and customer, was predominantly a manual driven process and was impacting services such as - SLA’s, accumulated requests and end client satisfaction ratings.

Solution

EVRY focused on the business imperatives and understood the actual provider enrollment and registration process. Our team analyzed the business requirements and obtained clarity on SLA’s agreed between the provider and end users. Based on the workflow analysis and business needs, EVRY designed a solution blueprint that automated pieces of the provider enrollment and registration workflows. Our subject matter experts presented the blueprint to the stakeholders for verification and acceptance of the solution.

We implemented the following features:

  • Utility tool to automate provider data load into the target system
  • Aggregation logic to easily bundle related provider tickets originating from various channels into a single request
  • Automatically initiate specific provider enrollment workflow based on consolidated requests
  • Created master template to accommodate all provider detail requests to support 80% of client Line of Business

Business Impact

  • Reduced service ticket resolution time by 20%
  • Lessened redundancy of operational staff by 10%
  • Improved resolution capacity of the support team by 10%
  • Forecasted improvement of customer satisfaction level by 5 points
Share on Facebook Tweet Share on LinkedIn