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.

1. OpenSpan for Healthcare
Better Way to Work & Better Way to Manage

2. where people and technology meet
© 2006-2013 by OpenSpan, Inc. All rights reserved.

3. 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.

4. 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.

5. 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.

6. Customer Experience
Better Business Processes Mean Better Customer Service
Client 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.

7. Cost Reduction
Automation of Manual Claims Activities Means Dramatic Savings
Client 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.

8. Membership Growth
Manage Growing Membership Without Increasing Expenses
Client 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 new
groups and state programs, and improve consistency in claim
payment quality.
© 2006-2013 by OpenSpan, Inc. All rights reserved.

9. Increased Compliance
Better Visibility and Automation Help Reduce Risk
Client Project:
In a recent audit, this Fortune 500 insurer discovered that prompt
pay penalties were being calculated incorrectly. The payer considered
hiring additional claims examiners to manually review and correct
the 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.

10. © 2006-2013 by OpenSpan, Inc. All rights reserved.

11. © 2006-2013 by OpenSpan, Inc. All rights reserved.