Published on August 1, 2009
Industry Healthcare Process Claims bills payment Increasing efficiency of claims bill payment process by 15 percent for one of UK's largest healthcare insurer Our client is one of UK's largest provider of health This process resulted in a growing suspense queue, delaying insurance and one of the largest insurers in the world. payment to the customer. There was clearly a need to Their health insurance products range from private medical improve the process, increase efficiency and customer insurance to income protection covering more than satisfaction. 750,000 lives. The WNS team realized that re-engineering the present The claims bill payment process involves managing the operational model would result in better customer service, medical bills for policy holders that are received from and significant cost savings. A LEAN Sigma project was specialists and hospitals in the UK under a cashless facility initiated to identify process gaps and increase efficiencies. and also managing the reimbursement bills from the policy holders. Among the key process improvements initiated were: Customer n experience In 2005, our client decided to offshore its claims bill Specialized teams were created based on bill prototype, payment process to India with the objective of increasing i.e. separate teams were created to work on individual, process efficiency while reducing cost. They chose WNS as small group and corporate bills. This simplified the their partner. training process as a CPA would only process one type of claim, hence increasing efficiency and improving The WNS Solution customer experience. Before outsourcing, all claims payment associates (CPA) would randomly receive corporate, small group and Six Sigma n process excellence individual bills for processing. The bills would then be Through - a Six Sigma process excellence program, suspended in the event any information was missing which further changes were implemented in the process. would be followed up by the CPA at a later date. Every CPA A separate suspense team was created for managing owned his own suspense queue, pursuing the suspended both the specialist and hospital bills. This team was claims each day. responsible to investigate and settle every bill that was Copyright © 2009 WNS Global Services | wns.com Industry: Healthcare | 01
suspended by the CPA. Since the team's primary job About WNS was to work on suspense bills, it was easier to follow up and settle the bills by a targeted planned WNS is a leading global business process outsourcing completion date. This Six Sigma project thus improved company. Deep industry and business process knowledge, the overall efficiency of the process and enabled the a partnership approach, comprehensive service offering and team to process larger volumes with the same number a proven track record enables WNS to deliver business value of FTEs. to the world’s leading companies. WNS is passionate about building a market leading company valued by our clients, The - suspense bills management team follows up employees, business partners, investors and communities. regularly with the UK counterparts to reduce inaccuracies and improve the turnaround time on the bill. Extending Your Enterprise Given the success of the LEAN Sigma initiative, the WNS team was able to improve efficiency by 15 percent and reduce the number of resources by 10 percent. Benefits delivered by the WNS team Increased n productivity gains - Separating the suspense processes from the bills processing increased productivity, resulting in better controls and rigorous quality measures while paying the bills. This translated into larger volumes being processed with improved customer service. Improved n accuracy - With the help of the LEAN initiative, the team increased the overall accuracy of bills being processed from a 98.50 percent to 99.50 percent thereby significantly reducing errors which result in incorrect payments or delays. Exceeded n savings target - WNS team exceeded the savings target by 8 percent in the first year of migration and 18 percent in the second year. To learn how we can help extend your enterprise, write to us at email@example.com Copyright © 2009 WNS Global Services | wns.com Industry: Healthcare | 02
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