<h3><span style="font-weight: normal;"> <b><span class="text-primary">Business outcomes</span></b></span></h3> <p>All MedPartners’ institutional claims now adjudicate automatically. The organization automatically transmits ANSI 835s to providers so they have direct visibility into claims volumes at their clearinghouse. We also helped MedPartners identify and address root causes of pending claims, reducing monthly pended claims to less than 10,000 per month, compared to as many as 30,000 to 60,000 claims previously. Only extremely complex claims now require human attention and manual adjudication.</p> <p>MedPartners’ auto-adjudication rate improved from an average of 40% to consistently more than 75%.&nbsp; The referral program, previously 100% manual, has now been automated by 50%.&nbsp; Operational efficiencies have increased by 50%, enabling MedParters to redeploy 25% of its staff to other key initiatives.</p> <p>Efficiencies from automation and integration powered by QNXT have generated an annual labor savings of more than $821,240. Provider service calls about claims have dropped by 20%, and provider appeals and disputes by 15%. The overall improvements, coupled with positive reductions in operations, have also raised health plan audit scores by more than 20%.</p> <p>Accurate, timely claims adjudication results in less friction for health plan members and their providers. Automated referrals expedite members’ access to the health services they need, which should lead to better health outcomes.</p>