Effective Healthcare Management
The healthcare business seems to get more complicated every day. Government regulations. Claims processing. Adjudication. And, of course, customer demands. All make your business processes more complex and costly.
HP can help. As a global leader in IT, we offer the best-in-class administrative services solution ?flexible technology that reduces costs and increases the effectiveness of healthcare management.
We also enhance your customer service through member contact centers, which handle benefit inquiries and enrollment in addition to researching member policy and claims information.
Healthcare Payer Administrative Services covers your needs end-to-end, including:
- Front-End Claims Processing and Management: When paper or electronic claims are received, we enter them into the system (electronic, imaging, manual), store the claims, print and mail necessary documents and handle all front end processes
- Claims Adjudication and Error Suspense Resolution: Following front end claims entry and handling, we manage the adjudication and resolution of all claims documents including error correction and issue resolution, workflow scheduling, quality assurance and reporting
- Enrollment Membership and Billing Services: Utilizing our systems or client's legacy systems ensures that members are properly enrolled so eligibility can be verified. We also ensure that employer groups are billed regularly for employee coverage
- Customer Service: Customer service may be via telephone, e-mail or Web-based means, and it includes incoming communications as well as outbound calls and responses
Focus On Growing Your Business
We know you don't want to spend your time on administrative functions. You want to focus on growing your business through initiatives like disease management and clinical functions. By outsourcing your healthcare administrative processes to HP, you'll free up valuable resources – money, time and staff – to do more important things. And you'll realize other business benefits as HP helps you to:
- Lower costs for claims, eligibility management and customer service functions
- Increase electronic enrollment from industry average of 50% to more than 80%
- Improve claims automatic adjudication rates from 40-50% to 80% or better
- Process claims and membership faster and more accurately, resulting in faster claims turnaround, payment and reporting (99% of claims in 15 days or less with 99% accuracy)
- Handle customer service inquiries more efficiently resulting in higher customer satisfaction levels (reduce direct phone inquiries by 50% through use of Web, interactive voice recording (IVR), and more accurate and timely processing; more than 80% of calls are completed with one encounter)
- Improve member retention and acquisition through faster and more cost-effective processes (98% of enrollment correctly renewed and installed on or before effective dates)
- Allow client to devote greater resources to development and implementation of new competitive marketplace offerings through a shift in focus and dollars towards these initiatives
HP Offers Industry Expertise And Results
When the world's leading healthcare insurers and government agencies need help expediting claims processing or with finance administration and disease management applications, they look to HP. By improving operational efficiencies and productivity, HP ensures that healthcare organizations receive the critical information they need to deliver quality care faster and more accurately.
We know your industry. HP administers more than 66 billion U.S. dollars in benefits annually for more than 15 different healthcare programs supporting nearly one million doctors, pharmacists and hospitals. And with HP performing 2.4 billion healthcare transactions annually, including 1 billion in claims, insurers can help patients receive the care they need more quickly. They accomplish this by turning to the world's business ally.
For more information about what HP Enterprise Services can do for you, submit a business inquiry.