The fundamental challenge facing the US Healthcare system is the counter intuitive notion of delivering less (in terms of declining utilization) for more (through higher spending). Addressing this productivity paradigm is within the immediate control of both Health Plans and providers.
We at Firstsource believe that delivering more (services) for less (cost), both administratively and clinically is the key to increasing healthcare productivity. Unlike other industries, healthcare has struggled to use innovation to sustain productivity gains. However, over the years, Firstsource, with its tools, technology and domain expertise has served as a catalyst for Health Plans and providers to address their productivity challenge.
With Firstsource, Payers can now process more transactions and service more constituents (members and Providers) at a lower cost. The ripple effect impacts key metrics such as the reduction in Administrative Loss Ratios (ALR) for Payers and the increase in Provider and Member Net Promoter Score (NPS).
With Firstsource, Health Plans can now process more transactions and service more constituents (members and Providers) at a lower cost. The ripple effect impacts key metrics such as the reduction in Administrative Loss Ratios (ALR) for Health Plans and the increase in Provider and Member Net Promoter Score (NPS).
Leading healthcare organizations, both Health Plans and Providers, trust Firstsource for the impact that we make on their top line revenues and bottom line profitability. This is because our clients entrust us with the delivery of a unique integration of domain expertise, process transformation culture, and proven workflow efficiency complimented by Robotic Process Automation (RPA) and Analytics technology.
We at Firstsource strongly believe that balanced incentives for the demand and supply side of the healthcare economy will be enabled by payment system reforms and population health management initiatives in the industry.
By partnering with Firstsource, Health Plans and Providers are better-positioned to achieve their missions and win within the context of these initiatives with our unique horizontal capabilities and deep Health Plans/Provider domain innovation and expertise.
One of America’s leading non-profit integrated health plan providers needed help to improve recording of Social Security Numbers (SSN) and Taxpayer Identification Numbers (TIN) information of its members, to comply with the provisions of the Affordable Care Act.
Firstsource used Sympraxis to increase efficiency in entering the missing data, reducing time and eliminating any room for errors. Once converted to the Sympraxis system for input, data entries increased significantly to an average of 5,000 entries per day. The system eliminated operational inefficiencies and delivered results in quick time.
A customised front end portal assisted in efficient data entry directly into the client database. Through the creation of this portal, Firstsource was able to deliver 60,000 files in 12 business days, ahead of schedule.
This allowed for an early start on phase 2 which included 25,000+ entries completed in 7 days.?All project deadlines were met in record time and Firstsource delivery exceeded client expectations.
One of the largest health insurance carriers in the US identified a 250% growth potential in business between 2013 and 2015 as a result of the Affordable Care Act (ACA), which stipulated a combined out-of pocket limit in 2014 for medical and drug costs.
The out-of-pocket limit is calculated and reconciled by a Firstsource reconciliation team. Multiple sources increase the complexity since the entire process is manual, giving room for errors. Firstsource implemented automation to avoid multiple screen navigation and automate excess and Out-of-Pocket (OOP) calculation, bringing down the transaction processing time by 25%.
Firstsource helped in bringing cost savings through productivity gains and improving the accuracy of the entire process. The client witnessed a 27% productivity improvement leading to a $1.2m cost saving across 3 years with additional potential of over $2m savings via replication.?Turn-around time dropped from 5 days to 2 days resulting in 250% increase in productivity.
The client approached Firstsource to help understand the reasons why patients were contacting them and for help to improve customer service. The Firstsource solution helped the client improve customer experience, reduce cost to serve and increase appointment rates for patients.
increase in contact deflection
increase in appointments via system optimisation
increase in patient experience scores
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We believe in long term partnerships - over half of our clients have been with us for 7 years or longer
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