Serco Global Services ‘s Healthcare Practice and Operations Leader rigorously study, assess, design and implement innovative process mechanisms that take advantage of the various industry regulations and policies to deliver rewarding operations for our clients.
Our services are designed and implemented in line with HIPAA, ISO and ICD standards. We also extend our services to support clients with trainings, implementation/up-gradations and audits for ensuring compliance to these standards.
Aligned to Regulatory changes……
Our Healthcare Solutions in this segment help clients navigate regulatory changes, benchmark their operations with peers, increase revenue, improve reimbursements, reduce dollar leakage and tame broken processes while driving compliances across all functions to lower costs and turn around times.
Success Story....Developed remedy plans for 75% of productivity losses
For a leading healthcare provider of hospital services, we implemented multiple consulting workshops to determine the HIPAA 5010 readiness and ICD-10 Readiness, where we assessed, documented, developed remedy process on shortfalls,
to deliver remedy plans for upto 75% of productivity losses with ICD 10 implementation. We further supported
the client with change implementation and trained
their staff on changes necessitated across process for compliance and adherence.
Navigating the Health Reform Law…
Our Healthcare services in this segment are aimed at supporting Payer organizations drive initiatives to navigate the impact of the Health Reform Law. We
help clients meet the ICD 10 deadline with minimum productivity losses and less impact on STP for claims.
Success Story....Adjudicated claims over USD 25,000
For a leading Global Health Insurance Company, we supported their New Business, Policy Administration and Billing services, by assessing their current process, benchmarking against industry standards, supporting process migration from legacy to new policy admin systems, adjudicated claims upto USD 25,000 and deployed our Collection Period Calculator to increase premium collection accuracy.
We also support global delivery for paper intensive processes through workflow and imaging solutions, as well as drive productivity by leveraging our efficient demographic and insurance eligibility verifications tools, collection prioritization and segmentation tools along with contact center and service center tools and platforms.
Success Story....Savings of over USD 2.6 Million
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For a leading provider of healthcare products and services, we implemented a complete solution to drive their customer service and billing processes, by initially documenting and standardizing their processes across branches, and then designing & deploying our in-house workflow solution to improve their paper-intensive processes inturn delivering savings of over USD 2.6 million in processing over 700,000 paper claims a month.
Segments supported by us include:
Healthcare Payers are looking for solutions that improve their administrative margins while fixing broken processes such as prior authorizations and claim adjudication. They are seeking service providers that help them transition through the upcoming challenges such as the increased PPACA driven enrollment and lowered productivity/lower STP on account of ICD 10.
Serco Global Services supports Payers across the Administrative cycle including Member Enrollment, Member Maintenance, Billings & Accounts Receivables, Provider Credentialing, Provider Management (Provider Authorization, Eligibility Verification, and Claim Status Enquiries), Analytics & Reporting and Finance & Accounting Services.
Healthcare Provider Organizations are seeking solutions that improve revenues, reimbursement, process compliance and stakeholder satisfaction while lowering operational costs and minimizing capital expenses. The Provider C suite is looking for credible, sustainable solutions to challenges they face which improve their financial and operational control while improving management visibility..
Serco Global Services supports Providers with Revenue Cycle Management services, including Payer Contract Management, Patient Registration, Pre-Authorization, Medical Coding, Payment Posting, Denial Management, Analytics & Reporting, and Accounts Receivable & Collections Management. Serco Global Services also supports this segment with multiple consulting & digitization services to consolidate and streamline processes to enhance revenue and compliance.
The Healthcare Markets are facing a perfect storm.
- An aging citizenry needs repeated high quality care driving up healthcare costs.
- Payers are renegotiating contracts, lowering reimbursement.
- Poverty is increasing leading to spiraling uncompensated charity care.
- Unemployment is driving increased self pay receivables leading to increased days AR and increasing write offs.
- Regulatory compliance is becoming crucial for sustaining reputations.
- Unfunded mandates such as HIPAA 5010 and ICD 10 are looming large on the horizon.
- The PPACA act is squeezing administrative margins while limiting cherry picking of risk.
The C-Suite is looking for cohesive partnership models to weather this storm with business impact solutions designed specifically for this industry segment.