Case study: Healthcare

Transforming provider engagement services from a cost center to a provider experience center

Client background

The client is a leading payer in the US.

Business challenge

We identified the need for improved provider lifecycle value. We proposed ways to reduce bot cost and lead-time spent on rework-related activities, which has helped to improve the quality of the delivered product.

The solution

The Sagility team implemented several initiatives gleaned from our experience across the payer-provider lifecycle, for both upstream and downstream impact. We assigned our team members to in-house strategies to:

Address claims rework returns with education and knowledge management.
Work on earning more same-day adjustments to quickly resolve query with the claims team.
Influence member NPS® through provider experience.
Tackle simple adjustments by empowering provider advocates to solve simple queries.

Results

We achieved real outcomes for our partner.

18% reduction in route-back cases (from 21% down to 3%)

1.39% reduction in adjusted cases (from 1.78% down to 0.39%)

24% decrease in maintained cases (from 28% down to 4%)

3.82% reduction in duplicate cases (from 3.9% to 0.08%)

Global locations

USA • India • Philippines • Jamaica • Colombia

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