Overview
eNoah helps an International Medical Record Company set up the process for retrieving the APS quicker for their clients.
Challenges
The largest APS Retrieval Company in the United States wanted to improve their APS turnaround time and to provide accurate Status of Medical Records. Due to diversified operations, the company had unsatisfied Insurance carriers. They required immediate transition of existing processes for better control and improved customer satisfaction. The company was under pressure to centralize operations within a short time frame to reduce time and cost challenges. They believed that centralized operations would significantly improve the process and decrease turnaround time for retrieving records resulting in happy clients for them. The irregularities during process handling were identified as critical. There were conflicting statuses about the current state of requests, which stressed the need of process control. There were several instances of not adequately stressing the purpose for record retrieval, due to which responses from facilities were relatively poor. The problem was much higher when there were many requests which could not be fully addressed, due to increase in volumes on specified days during the week. The company was keen to overcome this huge challenge and centralize operations by outsourcing the process of Record Retrieval. They wanted to immediately bring on board a single provider to address the Migration Process to deal with their growing list of unsatisfied Insurance carriers. The same challenges and needs as APS Summarization were encountered here as well:This involved the provider understanding the process ,then developing a robust process flow and standard training tool for knowledge transfer. The challenges they had hitherto encountered in the Migration Process were:
- Addressing all HIPAA regulations stringently to ensure confidentiality and security of health information
- Time and Resource Challenges in Recruitment and Training of employees on the Migrating process
- Standardizing the procedures involved in Summarization & Risk assessment
- Formulating Standardized procedures to procure accurate statuses from facilities
Our Solution
- eNoah’s end to end understanding of the Insurance business helped us get to the core and analyze the BGA’s key issues in developing workflow and standardizing the process and procedures .This resulted in quicker transition.
- The robust knowledge transfer tool we developed helped eNoah to Go-live within a short period from the date of training. As the extracted versus overlooked information in an APS goes right to the bottom line of insurers, eNoah deployed resources to run 100% Quality checks.
- The Internal Quality Assurance team at eNoah helped standardize the process and ensure summary accuracy through frequent training.
Key Benefits
- Provided better visibility to the process through Web enabled workflow. This resulted in agencies having uninterrupted access to updated status of summarization and related queries.
- Prompt and timely summarization resulted in reduction of time in the Risk Appraisal process.
- Helped our client concentrate on their core business while eNoah handled the medical underwriting.
- Helped achieve significant cost benefits on account of having a single service provider to address core business needs.
- As a result of better process, 80 % of summaries were delivered within 24 hours and the remaining 20% within 48 hours.
- The Internal Quality Control team at eNoah improved Process efficiency and enforced standardization of procedures for summarization.
- Customized summaries were provided as needed by the client.
- Fulfilling the demanding internal Quality Assurance recommendations provided by the team improved the overall rating of the summary.