Inc., a provider of innovative worker optimization, activity
management and automation solutions, today announced a recent
acceleration for OpenSpan Desktop Automation solutions among leading
national healthcare insurance providers within their contact center and
back office claims processing environments. Focused on driving down the
cost to serve within their contact center operations and minimizing
processing costs associated with claims adjudication, these
organizations are adopting OpenSpan's automation solutions to eliminate
redundant, manual activities and streamline worker processes for greater
operational efficiency and increased throughput.
Healthcare claims processing is an expensive and repetitive operation
that costs the healthcare insurance industry billions each year. Despite
investments in adjudication systems and other workflow tools, payers
still process between 10 to 50 percent of all claims manually. These
companies are turning to claims automation solutions like OpenSpan to
increase first-pass adjudication rates while leveraging their existing
technology investments. This results in a significant reduction in
processing administration costs, compliance with Medical Loss Ratio
(MLR) requirements, and an overall improvement in claims payment
Using OpenSpan, one healthcare insurance provider was able to reduce its
average claims processing time from 11 days to four, as well as decrease
the number of cal inquiries to the contact center by 75 percent.
Further, the provider was able to reduce the number of claims that were
greater than 15 days old, which decreased prompt pay penalties by
approximately 42 percent in the first year.
OpenSpan reports an increased adoption of its solutions among several
leading national healthcare insurance providers over the last six
months. "These healthcare insurance organizations face significant
challenges when it comes to reducing their administrative costs related
to the adjudication process," commented Rod Dunlap, vice president,
insurance for OpenSpan. "As new regulatory requirements are mandated
from the recently legislated Affordable Care Act, these organizations
must be agile and responsive to changes to comply with standards as they
are introduced. OpenSpan gives these companies the ability to rapidly
drive transformation within their claims processing business areas while
leveraging existing technology infrastructure."
In addition to optimizing claims processing business units, healthcare
insurance providers are also focused on driving down the cost to serve
in the contact center business units, but not at the expense of the
member service experience. "Healthcare insurance member service is very
different from a consumer customer experience in that it is a more
emotional, private situation or circumstance," said Anna Convery,
executive vice president of Strategy for OpenSpan. "Providers realize
they must equip their employees with the tools to effectively handle all
member interactions in a timely, thorough manner, and with the integrity
and credibility expected to maintain a sense of trust and confidence."
For contact centers, OpenSpan Desktop Automation streamlines worker
activity and eliminates the need for agents to navigate between complex
systems and applications. Additionally, process automation enables these
organizations to maintain compliance to industry standards like HIPAA.
"Using an agile desktop environment powered via OpenSpan, these
healthcare insurance organizations empower their agents to deliver
faster, more accurate responses to inquiries, resulting in higher member
satisfaction," added Convery.
OpenSpan is a provider of activity intelligence and desktop automation
solutions that improve performance, drive revenue and increase
efficiencies in contact center, back office and retail storefront
environments. Activity Intelligence provides actionable, real-time
activity and performance insight used to make informed decisions about
people and technologies. Leveraging the critical insight from desktop
analytics, organizations use desktop automation to streamline worker
activity, simplify critical service processes and remove technology
barriers as means to deliver a gold-standard customer experience.
OpenSpan solutions are deployed on more than 300,000 desktops across the
world, and are optimizing billions of transactions in the banking and
financial services, insurance, telecommunications, retail and technology
industries. For more information, visit www.openspan.com.
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