Sushil Ghorpade
Multi-site Processing using Exela's Payment and Claims Processing Solution
Challenge
The client, a reputable healthcare organization, had high volumes of B2B payments and endless claims waiting to be processed. This situation was only worsened by the COVID-19 crisis, resulting in backlogs, flawed workflows, and delays. The reason – they were using an inadequate solution. The client was overburdened using a process with multiple handoffs for payments and claims. As a result, the organization desperately sought a reliable partner to align with its long-term digital transformation initiatives and support a combined goal of more efficient payment and claims processing.
This was the original timeline for their existing process:
Deposits: 7 to 10 days
Reconciliation: 4 to 6 weeks
Solution
Exela provided the client with a one-stop solution to process both payments and claims. We used our payment processing platform, TMS, to deposit checks received by customers, instantly reducing the TAT for deposits. Explanations of Benefits (EOBs) were processed using our PCH Global solution to generate automated 835 files. Moreover, the health organization’s treasuries greatly benefitted in reducing their TATs using our augmented payment and claims processing solution. The client also developed resiliency using Exela's hub-and-spoke model to support the new process, avoiding any adverse impact with a robust DR solution. Additionally, handoffs between deposits and reconciliation were subsequently reduced.
Here is how we performed compared to their original timeline:
Deposits: Same day!
Reconciliation: Within 48 hours!
Benefits
- Exela processed exclusive volumes for the organization, amounting to a $16 million ACV engagement for the next 12 months.
- Significant scalability using a fully variable solution model.
- Access to an extensive set of platform tools.
- Customers had options of add-ons to up-sell products and services with benefits reaching the end customer.
- Reduced efforts for all stakeholders involved – the Payer, the Provider, and the Bank.
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