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Medica Case3 Improved Provider Directory Accuracy.pptx

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Medica Case3 Improved Provider Directory Accuracy.pptx

  1. 1. © FIRSTSOURCE 2023 | CONFIDENTIAL | 1 Improved Provider Directory Accuracy for a Minnesota based American managed health care company Client Objectives • It was identified that 60% of the errors in the secondary database were caused by – 1. Non-standardized input formats and 2. Information discrepancies between the client’s primary and secondary databases. • Due to multiple input sources, the operations team was finding it a challenge to maintain a zero-error workflow. These were causing delays in processing claims and discrepancies in payments. Firstsource Solution Firstsource implemented Sympraxis powered Automated Workflow + Robotic Process Automation (RPA) solution. This included – • Business rule validation of data in both databases • RPA technology to validate information update quality and to simplify ‘Source of Truth’ (SoT) validation process complexity • Six Sigma data-driven methodology to eliminate or minimize errors in processes Business Outcomes • Eliminated visual comparison of data and improved quality from 99% to 100% • 8-day reduction in average turn-around time (from 10 to less than 2 days) • Processing time reduced from 45 min to 9 min (80% Improvement) • Consistent achievement of SLA for quality Minnesota based American managed health care company 8 Day Reduction in TAT $

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