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Our client is one of UK's largest provider of health insurance and one of the largest insurers in the world. Their health insurance products range from private medical insurance to income protection covering more than 750,000 lives.
The claims bill payment process involves managing the medical bills for policy holders that are received from specialists and hospitals in the U.K. under a cashless facility and also managing the reimbursement bills from the policy holders.
In 2005, our client decided to offshore its claims bill payment process to India with the objective of increasing process efficiency while reducing cost. They chose WNS as their partner.
Before outsourcing, all claims payment associates (CPA) would randomly receive corporate, small group and individual bills for processing. The bills would then be suspended in the event any information was missing which would be followed up by the CPA at a later date. Every CPA owned his own suspense queue, pursuing the suspended claims each day.
This process resulted in a growing suspense queue, delaying payment to the customer. There was clearly a need to improve the process, increase efficiency and customer satisfaction.
The WNS team realized that re-engineering the present operational model would result in better customer service, and significant cost savings. A LEAN Sigma project was initiated to identify process gaps and increase efficiencies
Among the key process improvements initiated were
Given the success of the LEAN Sigma initiative, the WNS team was able to improve efficiency by 15 percent and reduce the number of resources by 10 percent.