openspan for healthcare in claims and customer service
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In an ever-evolving industry, health insurers face a constant barrage of new regulations, increasing competitive pressures and rising costs that threaten their ability to deliver excellent service to new and existing members. To succeed, they must improve operational efficiency.TRANSCRIPT
OpenSpan for HealthcareBetter Way to Work & Better Way to Manage
© 2006-2013 by OpenSpan, Inc. All rights reserved.
where people and technology meet
© 2006-2013 by OpenSpan, Inc. All rights reserved.
What OpenSpan Means to Healthcare Payers
In an ever-evolving industry, health insurers face a constant barrage of new regulations, increasing competitive pressures and rising costs that threaten their ability to deliver excellent service to new and existing members. To succeed, they must improve operational efficiency.
Our health insurance customers are more agile. With OpenSpan they have a significant competitive advantage in Claims and Customer Service because our automation and analytics tools help them:
Recognize significant cost savings.Improve performance and raise customer satisfaction in the front office.Achieve record membership growth and retention.Maintain compliance in an environment of constant change.
Best of all they saw results in weeks, not years.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
OpenSpan has solutions designed specifically for healthcare insurers…But we are used in virtually every other industry too, with Fortune 500 customers in banking and financial services, telecommunications, retail and technology markets including:
Three of the top six managed health plans in the Fortune 500.Three of the top five property and casualty insurers in the Fortune 500.Three of the U.K. “Big Four” and four of the top six U.S. commercial banks in the Fortune 500.Seven of the top global telecom/cable providers.One of the world’s three largest computer hardware manufacturers.Two of the top five U.S. food and drug retailers in the Fortune 500.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
OpenSpan’s innovative technology and deep expertise in healthcare insurance can help you boost productivity enterprise-wide with near-immediate ROI.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
Customer Experience
Better Business Processes Mean Better Customer ServiceClient Project: This healthcare payer, a division of one of the largest insurance companies in the Southeastern United States, used OpenSpan’s Claims Repair Service to reduce average claims processing time from 11 days to just four.
Project Results:Member and provider satisfaction has increased due to more timely claim payments.Faster payment of claims has reduced claim inquiries to the call center by almost 75%.By significantly reducing the number of claims >15 days old, prompt pay penalties dropped by 42% in the first year.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
Cost Reduction
Automation of Manual Claims Activities Means Dramatic SavingsClient Project: This major healthcare payer needed a faster way to add new providers to their claim payment system to reduce errors, payment delays and labor costs associated with the time-consuming manual process.
Project Results:The time to process new provider claims dropped from 30 days to just one, significantly reducing labor costs, prompt pay penalties and duplicate claim submissions.Ultimately, OpenSpan improvements are expected to reduce administrative costs by over $5,000,000 annually.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
Membership Growth
Manage Growing Membership Without Increasing ExpensesClient Project: Membership at this payer was growing at 30% per year, and variable expenses were climbing even faster. To handle the increasing volume of claims, they selected OpenSpan’s Claims Automation Service.
Project Results:With OpenSpan, the payer was able to eliminate up to 50% of the manual activities associated with processing suspended claims, including duplicates, authorizations, pricing and COBs.Due to increased efficiency in the claims operation, the payer did not increase claim processing staff or budget.The payer was able to accelerate the on-boarding of newgroups and state programs, and improve consistency in claim payment quality.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
Increased Compliance
Better Visibility and Automation Help Reduce RiskClient Project: In a recent audit, this Fortune 500 insurer discovered that promptpay penalties were being calculated incorrectly. The payer considered hiring additional claims examiners to manually review and correctthe errors.
Project Results:Within four weeks the insurer had a solution in place using the OpenSpan Claims Automation Service which allows them to accurately track and report prompt pay payments. The OpenSpan solution saved the company 25 potential new hires, and an additional $350,000 annually in labor costs related to prompt pay auditing on new claims.
© 2006-2013 by OpenSpan, Inc. All rights reserved.
© 2006-2013 by OpenSpan, Inc. All rights reserved.