The client was looking for a software service vendor to automate the claims adjudication process.

Challenges

• Availability of resources with its domain expertise and technical skills
• Time consuming manual process of claim adjudication
• Piling up backlogs

Solution

• Analyzed existing business processes of the client's adjudication system
• Implemented GreenClaim – healthmason and automated the adjudication process

Results

• Automated the adjudication process thereby bringing increased productivity
• Eliminated cost escalations
• Process stabilization and consistency
• Accurate outputs and predictable work quality
• Transaction based pricing (Solution as a Service)

Evidence of Success

• Client successfully auto adjudicated a total of 1,350 claims in two months from the time of implementation
• With the help of healthmason, client achieved 96% accuracy in processing claims