ACHIEVED 30% REDUCTION IN TCO AND ENHANCED CUSTOMER EXPERIENCE FOR A LEADING US HEALTHCARE PROVIDER

THE CLIENT

A US based leader in providing patient-specific, data-driven technology and solutions.

BUSINESS OBJECTIVE :

The client aimed to assess their current company operations, including people, processes, and technology, to increase customer satisfaction, modernize outdated systems, and build lean and standardized methods while ensuring compliance. To achieve these goals, they needed to consolidate and improve the core platforms, expand automation efforts, drive data-driven business decisions and eliminate resourcing issues leading to low IT agility, high technical debt, and cost implications.

SOLUTION

Mphasis conducted a blueprinting exercise using the 4D Consulting framework to understand the as-is state of the client’s organizations and design an ideal Target Operating Model with technology transformation, enhanced customer experience, improved processes and reduced TCO. We implemented our BPaaS solution across people, processes, and technology. We delivered the below services in an integrated manner :

Enabled Zero Cost Transformation to reduce run costs by automating processes.
Consolidated and Migrated TPA applications to Mphasis’s proprietary Javelina Platform
Built and supported EMR applications and rearchitected the PACE platform for reuse (Enhancements & Product convergence)
Provided Agile pods and Managed resourcing with right onshore and offshore mix.
Improved business continuity and resiliency for the Hybrid Workplace through Staff Consolidation & shared service model
Ensured HIPAA & HITECH Compliance
Implemented Omni-channel contact center platform with Intelligent IVR, Chat & Voice Bots; Self-service portal
Implemented RPA, data analytics & ensured process standardization with industry standard SLAs and KPIs
Supported processes - Enrollment, Claims Management (Intake, Adjudication, COB processing, Appeals, Audit etc.,), Billing & Accounting, provider network maintenance, Benefits Configuration, Regulatory & Compliance, Contact center etc.