Case Study: Healthcare

Leading physician network provider improves data accuracy with PDM, saving nearly $1 million

Sagility accelerated collections, reduced receivables, and avoided write-offs

Overview

Sagility supported a leading physician network provider with Provider Forward to save nearly $1 million, improve data quality, and reduce provider abrasion.

$800K in annual savings

$155K in credentialing cost savings

90K updates/month in six months

Client background

Access to care that affects Star ratings is a challenge for many payers. One leading physician network provider was looking to reduce costs and improve the quality of their PDM and credentialing solutions.

Business Challenge

As a provider of physician networks, the client struggled with managing large volume of unclean rosters and manually scrubbing and entering them into the system. As a result, the propensity of errors was high due to data entry and interpretation errors. This impacted customer relationships and Star ratings. As healthcare companies increasingly look to improve the integrity of their data, the client sought Sagility’s help to increase savings and improve the quality of their provider database management.

The solution

Sagility provided an automated solution that created multiple channels of inventory intake, along with structuring and standardizing the intake template. The behind-the-scenes activities resulted in reduction of ~80% manual work and improving data accuracy to 99.9%.

Leveraged Automated Roster Management Solution

To address the challenge, Sagility leveraged the proprietary Network Management solution Provider Forward, a CRM-based platform with built-in automations and interfacing abilities. The specific solution contains a universe of varied roster formats and dictionary; through its advanced business rules, the system populates accurate results eliminating manual effort and tribal knowledge. The solution was designed in three phases:-Define standard table for data points that are mostly varied. -Clean up and standardize data elements that are unstructured.-Update client systems through ICP tools in industry-standard formats.

The solution was designed in three phases:

Define standard table for data points that are mostly varied.
Clean up and standardize data elements that are unstructured.
Update client systems through ICP tools in industry-standard formats.

Results

Sagility delivers provider data updates and maintenance from Hyderabad and Bangalore. Here are a few results:

$100K In annual savings with PDM support

$200K In credentialing cost savings with approx. 70% decrease in end-to-end processing time

99.9%Database quality of transactions processed through automation maintained

100K – 120K Increased updates/month within six months

70% Efficiency in transactions per hour

100%Adherence to NSA rule and enabling additional savings of +$25K in penalties to CMS

Global locations

USA • India • Philippines • Jamaica • Colombia

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