Efficiency

Client

National Healthcare Benefits Administrator

The client provides technology solutions for the Healthcare industry in processing patient enrollment, benefit plan administration, and claims processing for third-party administrators and account care organizations throughout hospital systems nationwide.

Challenge

Claims processing took two hours and was riddled with errors. Patient enrollment required multiple external file acquisitions from many sources and was plagued with errors as well. There was no visibility or control in the stages of these processes. Solutions were attempted by the client’s in-house development team, but none solved the issues.

Solution

Aperia developed a solution that dynamically ingests and monitors inbound files, generates processing statistics, normalizes data through a rules-based validation engine, and ensures complete and accurate output. Claims processing time dropped from 120 minutes to 8 minutes. We scoped, designed, and delivered the solution in four weeks and at half the cost of other bids.