Claims Leakage Mitigation

Minimising claims leakage through targeted strategies boosts healthcare revenue and operational efficiency

Industry:

Healthcare

Claims leakage in healthcare leads to financial losses and inefficiencies. Inteliment partnered with a healthcare provider to implement advanced analytics and process improvements to reduce leakage and enhance revenue recovery.

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Challenges

High Claims Denial Rates: Elevated denials due to incomplete or inaccurate claims information.
Inefficient Claims Processing: Manual processing caused delays and errors.
Lack of Visibility into Claims Performance: Absence of real-time data hindered trend identification and root cause analysis.

Solutions

Advanced Analytics Implementation: Deployed predictive analytics to identify patterns in claims denials and leakage.
Claims Processing Automation: Introduced robotic process automation (RPA) to streamline repetitive tasks and reduce errors.
Enhanced Training Programs: Developed training to improve accuracy in claims submissions.