Payment Process Efficiency Eliminates 23% of Unprofitable Relationships for Healthcare Service Provider

Capabilities
Healthcare
Healthcare provider on laptop

Challenge

A healthcare service provider faced increased OPEX and decreased revenue due to costly and inefficient operating structures.

The company needed to assess its operations to identify benefits through more cost-effective and efficient operating structure for payments.

Approach

  • Assessed the end-to-end payment integrity process to identify opportunities to increase capacity without expanding the workforce
  • Captured and validated data from 2 operating businesses to define the current-state landscape
  • Fully assessed the technology platform and data quality to develop technology platform modernization and master data management
  • Used PCR segmentation to align effort level to increase savings per case and recovery speed

Results

Number 1

Eliminated unprofitable relationships with 23% of Provider-Client Relationships (PCR)

Number 2

Identified 5% in total benefits via Capacity Optimization, Labor Arbitrage, and Span of Control

Number 3

Implemented quick win improvements to technology platform

Experts