Enhancing Healthcare Operations Via Claims Workflow Automation

Healthcare

THE CHALLENGE.

Recently, a major healthcare provider came to Pegasus One looking for new ways to maximize the capabilities of their core administration system. The major problem stemmed from the fact that they didn’t exactly have an effective claims management workflow strategy – which was a problem that was only getting worse as time went on. Claims would need to be manually forwarded to various processing departments and back again, causing costly delays and frustration for everyone involved.

Luckily, we had more than a few ideas on how to help relieve some of this pressure in such a high stakes environment.

Enhancing Healthcare Operations Via Claims Workflow Automation

Healthcare

THE CHALLENGE.

Recently, a major healthcare provider came to Pegasus One looking for new ways to maximize the capabilities of their core administration system. The major problem stemmed from the fact that they didn’t exactly have an effective claims management workflow strategy – which was a problem that was only getting worse as time went on. Claims would need to be manually forwarded to various processing departments and back again, causing costly delays and frustration for everyone involved.

Luckily, we had more than a few ideas on how to help relieve some of this pressure in such a high stakes environment.

APPROACH.

The team at Pegasus One immediately got to work, leveraging our custom workflow application to the client’s advantage. We were able to replace their cumbersome manual reports and spreadsheets with real-time management views.

Claims supervisors can now locate a claim and track its status in an ongoing way, all from one easy-to-use screen. Likewise, senior management is automatically alerted to certain pressing issues – thus saving even more time across the board.

RESULTS.

After implementing our custom workflow solution, the client was able to enjoy a number of critical benefits – essentially all at the same time. Not only were they able to enjoy an almost immediate 34% increase in processing productivity, but they were also dealing with far fewer penalties as well. They saw a 17% decrease in penalty payments year-over-year after the solution was implemented.

All told, Pegasus One’s solution was able to reduce costs, enhance member and provider satisfaction, and dramatically improve productivity for the client. All of this was possible thanks to automating claims tracking and workload management processes – and make no mistake about it, the team was more than happy to help out in any way that we could.

Improved Productivity

34% increase in processing productivity

LESSER PENALTIES

17% decrease in penalty payments 2016 YTD compared to 2017 YTD

VALUE.

Our solution reduced costs, enhanced member and provider satisfaction, and improved productivity for the client by automating its claims tracking and workload management processes.