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Healthcare

Digital Solution Facilitates Profitable Growth in Healthcare Services


The Challenge

A healthcare services company that offers billing services and revenue cycle management to hospitals, clinics and medical offices quickly grew to become a national service provider—handling billing for 200 million patient visits. Wanting to ensure it managed its growth efficiently and profitably, the company engaged Cognizant's enterprise services to help.


Our Approach

Cognizant developed and implemented a single IT platform for all the company's data operations. With this platform in place, we helped implement several scalable solutions to improve operations management. These included an operations management system for reporting and accounts receivable follow-up, root cause analysis to understand and fix problems with claims rejection, and a series of Six Sigma projects to improve quality in several key lifecycle processes.

More recently, when the company matured and its growth rate slowed, we helped develop a robotic process automation (RPA) solution to automate claims and payment processing.

Digital Solution Streamlines and Improves Operational Quality and Productivity

Over the course of a nine-year relationship, Cognizant has helped the company drive performance across numerous industry metrics, including improving coding accuracy, cutting the claims rejection rate, lowering denial rates and reducing days in accounts receivable. This has helped the company accomplish its long-term goals of world-class service and efficient profitable growth.

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89% to 97%

improvement in coding accuracy

3%

or less claims rejection rate

4%

claims denial rate

Doubled

productivity from 40 to 80 transactions per hour


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