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Case Study: Remittance Processing
Third-party Insurance Administrator welcomes the know-how of document process outsourcing professionals.
Challenge
The client performed the time-consuming tasks of opening, prepping and sorting all claims to be processed in-house. They then manually extracted and verified data in order to process the claims.
Solution
Berkheimer customized a solution that not only reduced the amount of time it took to process claims, but it also cut costs associated with this process. One additional benefit was the regaining of space used to house these documents.
Results
The company has relied on Berkheimer as a trusted resource to process their claim documents. As a result, they have less errors in claims processing and at a significantly faster rate of speed than in the past.
The third-party administrator offers customized claim and medical management services to increase productivity and contain costs. They offer services in various types of claims processing including workers’ compensation, auto and general liability claims management, medical and field case management, and integrated workers’ compensation and disability management programs.
Prior to their decision to outsource, the client relied on internal staff to process bills and claims that they received from providers and external claims offices. The manual execution was tedious and seemed to cause unnecessary delays in payments. The company sought an alternative that would allow them to process bills more efficiently. They ultimately selected Berkheimer Outsourcing as their trusted provider for a comprehensive solution that would save them time, money and resources.
In 2005 Berkheimer implemented a custom solution for this client that would include the opening, prepping and sorting of all incoming mail for the client. Once opened and prepared, the claims are then scanned through OCR. Each bill has certain key information that is then verifi ed such as bill class, unique ID and state. All of the data is collected and then uploaded to the client’s server for additional data entry. The original documents are then physically stored at the Berkheimer storage facility for a specified period of time. In this case, it is 60 days, Documents are then shredded. Due to the nature of the documents, the entire process is handled in a HIPAA compliant environment.
Berkheimer processes approximately 800,000 pages of bills and attachments per month for this client totaling 10.8 million pages per year. What was taking the client 3.5 hours to complete has now been streamlined to take an average of approximately 1.9 hours. This improved the process efficiency by 54%. The committed turn around time from document receipt to image upload is 24 hours, but normal turnaround times rarely reaches that limit.
Additionally, the project resulted in a reduced volume of bills processed monthly due to a more efficient process. The handling of unnecessary duplicates and lost bills has been eliminated. Berkheimer began receiving 160,000 - 185,000 bills monthly. Their process solution has now streamlined the number to approximately 130,000 - 140,000 claims per month.
“We were able to reduce the amount of time it took to process a tray of mail from three and a half hours to just under 2 hours.” -BOS Technical RepresentativeThe efficiencies gained in processing time combined with the reduction in overhead has allowed the client to eliminate a non-core process and to concentrate on their central business processes.