A Healthcare company that focuses exclusively on providing government-sponsored managed care services, in North America, required to automate business processes to improve provide on-boarding timeframe, for market competitiveness.
The ChallengeProvide a system to accelerate provider network enhancement.
- Provide a unified Provider 360 view.
- Maintain data integrity between three core existing business systems (Prospecting, Contracting and Provider Relations) in ever changing business scenarios.
Avoid swivel chair and provide a unified work space.
- Need to automate business processes to improve provide on-boarding time frame for market.
The SolutionA unified, automated provider contracting platform that modernized all aspects of the client’s complex provider relationships.
- Integrated smart BPM to manage workflow, SLA, business rules, integrations with internal systems and provide regular updates to consuming systems.
- Parallel processing of cases by creating sub cases and tasks.
- Intelligent routing of cases based on agent availability, skill and work load.
- The Network Management application was built as an end–to-end solution, which empowered business to configure state-specific rules.
- This reduced dependency on technical resources, thereby debottlenecking the process and accelerating time to market.
The BenefitAutomated Provider Contracting by leveraging industry-leading HCIF and other core PRPC workflows & business rules.
- Slashed the client’s Provider onboarding time frame from 90 days to 40 days, a 53% reduction.
- 587 use cases built in just 020 weeks with 70% of functionalities being re-usable.
- Onboarding time for standard contracts reduced to 15 days.
- Complete elimination of documenting misses and errors.