Client
A Trusted Name in Compassionate Care
Our client is a prominent multi-specialty medical group in the United States, widely recognized for its commitment to clinical excellence and compassionate care. Serving thousands of patients daily, the organization has built a strong reputation for delivering high-quality healthcare. However, as the healthcare landscape rapidly evolved, the client faced growing challenges in scaling operations and maintaining a seamless, patient-centered experience. Driven by a bold vision to transform care delivery, they set out to achieve digital transformation in healthcare through optimized workflows, integration of fragmented systems, and consistent, high-quality interactions across every touchpoint in the patient journey.
Challenge
Overcoming Silos and Operational Complexity
Several challenges impacted the client’s operational efficiency and patient satisfaction:
- Broken Revenue Cycle Workflows
High denial rates, manual claims processing, and limited cash flow visibility placed a heavy strain on financial processes and administrative staff.
- Disconnected Nurse Triage Systems
Inconsistent clinical guidance, limited access, long response times, and poor after-hours support left patients feeling underserved during critical moments.
- Operational Inefficiencies
Administrative teams struggled with duplicated efforts, siloed tools, and rigid workflows, significantly limiting scalability and the ability to adapt to patient needs.
- Fragmented Patient Experience
Siloed systems across various touchpoints of care delivery resulted in poor communication, leaving patients feeling unsupported, increasing dissatisfaction and drop-offs.
These challenges made it difficult for the organization to achieve its long-term goals of delivering seamless, patient-first care while maintaining operational excellence.
Solution
Hexaware’s Human-Centered Digital Transformation Framework
Hexaware designed and implemented a holistic digital transformation strategy with human-centered care at its heart. The solutions focused on leveraging advanced technologies, unifying systems, and scaling operations without compromising quality.
Centralized Nurse Triage Command Center
Hexaware replaced fragmented triage workflows with a single, integrated system powered by intelligent automation. This enabled 24/7 support with consistent clinical advice and faster response times.
- Results:
- Significant reduction in patient response time
- Consistent guidance across all triage interactions
- Improved patient satisfaction for urgent care needs
AI-Driven Revenue Cycle Transformation
Hexaware introduced predictive analytics and automation tools to streamline claims processing, reducing denials, and accelerating reimbursements.
- Results:
- 25% reduction in claims denial rates
- Revenue cycle processing sped up by 2x
- Enhanced provider-payer alignment and cash flow visibility
Unified Patient Engagement Ecosystem
Hexaware implemented cloud solutions for healthcare through a platform that connects every touchpoint in the patient journey, from scheduling appointments to post-care follow-ups.
- Results:
- One-click appointment scheduling, reminders, and feedback collection
- Unified patient records across departments
- Increased care adherence and patient retention rates
Scalable Global Delivery Model
Hexaware established a global healthcare operations team through Centers of Excellence (CoEs) to provide 24/7 support, ensure high SLA compliance, and continuously optimize processes.
- Results:
- Reduction in operational costs
- Improved turnaround times with seamless staffing coverage
- Resilient workflows ensuring consistent healthcare delivery
Benefits
Transformative Results for Patients and Operations
The transformation delivered measurable results, empowering the organization to achieve its goals for operational excellence and patient-centric care.
Key Benefits:
- 40% Improvement in Nurse Triage Efficiency: Faster clinical responses reduced patient wait times and improved service quality.
- 20% Reduction in Operational Costs: Leaner, more sustainable operations with optimized workflows.
- Enhanced Patient Satisfaction Scores (CSAT/NPS): Reflecting stronger trust, loyalty, and engagement.
- Standardized Clinical Workflows: Ensuring consistent, high-quality care delivery across the organization.
Summary
A Roadmap to the Future of Healthcare
A leading multi-specialty medical group in the U.S. partnered with Hexaware to overcome operational inefficiencies and fragmented patient experiences. Facing challenges like broken revenue cycle workflows, disconnected nurse triage systems, and siloed tools, the organization sought a transformative solution. Hexaware implemented a human-centered digital transformation framework, introducing AI-driven revenue cycle automation, a centralized nurse triage command center, and a unified patient engagement ecosystem. These innovations led to a 40% improvement in triage efficiency, a 25% reduction in claims denials, and enhanced patient satisfaction. This case study showcases how AI in healthcare and empathy can work together to deliver scalable, patient-first healthcare.
