Healthcare Coding Company

Healthcare Coding Company

Coding Decoded: Compliance, Speed, Quality, and Value

Customer Lifecycle Management
|
Healthcare & Pharmaceuticals
PDF

 

This organization, a Fortune 100 health benefits company, serves nearly 67 million people through its affiliated companies, including nearly 37 million enrolled in its family of health plans. 

Challenge

The company was not hitting service metrics such as 24-hour end-to-end turnaround times, and manual processing was inflating its per-transaction costs. The firm wanted a comprehensive, automated solution that would also address sluggish chart recycling, which were further adding to delays.
 
The company approached Aptara in need of a partner who could:
  • Demonstrate a regulatory compliance track-record in healthcare 
  • Process up to 25,000 charts per month
  • Meet an abbreviated 1-month ramp-up requirement  
  • Hit service-level agreements (SLAs) by the end of that month
  • Add value to current processes

Solution

Aptara developed a solution that combined highly skilled personnel with user-friendly technology to achieve a 24-hour turnaround time -- from day one.
 
During the brief transition, Aptara teams collaborated with client teams using, real-time reporting to manage staff and assess the workflow. After recruiting employees for the processing center, Aptara conducted web-based training in the new procedures and built out an IT infrastructure.

Result

In addition to a streamlined process that meets turnaround targets, the teams:
  • Achieved quality target metrics by the second week
  • Surpassed quality performance SLAs (SLA: 98%; actual: 99%)
  • Decreased keystrokes per claim from 185 to 85, thereby reducing per-transaction costs significantly