Healthcare InsuranceHealthcare insurance organizations use Comprehend to improve claims operations, auditing practices, and membership and enrollment functions resulting in immediate cost savings and increased profitability.
Administrative costs for Health Insurance providers exceeded $91 Billion in 2009. A large portion of costs were directly related to claims processing, with the average manual claim costing $2.05 to adjudicate. There are over $50 Billion in overpaid claims each year. Errors in claims can result in not only overpayments, but underpayments that can even be more costly due to penalties and interest costs associated. Additionally, a large part of administrative costs are driven through contact centers where multiple systems and applications are required to service customers, rework is high, and self service adoption is low. Improving the productivity and service provided by operations will be critical to competing in the changing insurance market.
SolutionThe OpenConnect Comprehend solution provides the detailed event-based intelligence around the complete claims operation and member service process.
OpenConnect Comprehend provides quantifiable results, improves claims operations immediately, and has a positive ROI within one-year of deployment.
From a claims operations perspective, OpenConnect Comprehend allows healthcare insurance organizations to:
With Comprehend you can improve your Operational First Pass Rate, decrease adjustments and rework, reduce penalties and interest, and lower your administrative expense while improving customer service.
Key Customers Include: