Client
Our client is a multi-specialty, physician-directed medical group in the US that delivers healthcare management solutions for personalized care, handling over 300,000 annual patient visits over multiple locations.
Challenge
The client faced multiple operational challenges that hindered their ability to improve patient experience:
- The need to increase overall CSAT through personalized care approaches
- A multi-partner landscape affecting patient experience consistency
- The necessity to improve net collection to achieve top-tier industry standards
What the client needed:
To overcome these hurdles, the client sought a partner that could help them transform patient experiences, reduce operational complexities, and streamline revenue cycle processes.
Solution
Hexaware provided a comprehensive solution to address the client’s challenges, focusing on optimizing operational processes, improving patient interactions, and upgrading technology infrastructure. The goal was to standardize operations and boost overall patient satisfaction.
Scope:
Revenue Cycle Management: We automated coding processes and supported the client in managing billing services, payment processing, AR management, patient statement services, and credit/refund oversight. Additionally, a patient financial contact center was established to handle financial interactions.
Centralized Nurse Triage System: We set up a centralized system where nurses could remotely assess patient health concerns through phone and messaging channels. This included triaging health issues, managing medication refills, scheduling appointments, and handling insurance authorizations using approved protocols.
Inbound Call Handling: Our team took charge of handling new user registrations, updating patient information, and managing appointments using the EPIC system.
Records Management: We managed back-office indexing and the review of patient medical information from scanned documents for multiple locations.
Highlights:
Technology Integration: We integrated next-generation tools into the client’s existing customer experience platform to enhance patient interactions.
Multi-location Strategy: We delivered services through a global delivery model with work-from-home teams in the US and delivery centers in India, the Philippines, and Mexico.
Two-vendor Approach: We streamlined their operations to a two-vendor model to align performance and mitigate risks.
Patient Portal Adoption: We supported the client in leveraging the EPIC system to drive the adoption of myChart patient portal, enabling better patient access to health information and enhancing overall engagement.
Technology Consulting: Hexaware advised the client on upgrading their contact center technology from Five9 to Genesys for better operational efficiency, and to enable self-service and automation.
Center of Excellence (CoE): We established a CoE to facilitate improved collaboration between front-end, back-end, and client teams.
AI-enabled Training: We leveraged our automation platform, Tensai®, to implement an AI-powered smart training tool to enhance the training of agents and nurses, focusing on delivering patient-centric care and improving satisfaction levels.
Apart from these initiatives, Hexaware recommended that the client enhance patient engagement channels by implementing chat and chatbots to improve accessibility and responsiveness.
Benefits
Hexaware’s comprehensive solution delivered significant improvements in operational efficiency, patient engagement, and financial outcomes for the healthcare management solutions provider:
- Reduced TCO by 30% over a 3-year contract period
- Increased net collection to over 90% from Day 1
- Reduced denial rate by 20%
- Improved first call resolution (FCR) to over 80%
- Reduced repeat calls to less than 10%
- Reduced call volume by 23% through digital channels
- Achieved an interaction CSAT score of over 90%
- Improved quality scores to over 95%
Summary
The client, a leading multi-specialty medical group in the US providing patient-centered healthcare management services, faced challenges in standardizing operations, improving patient experience, and achieving financial targets. To address these issues, Hexaware provided a tailored solution that included optimizing revenue cycle management, centralizing nurse triage services, and enhancing the use of the EPIC system for better patient portal adoption. Additionally, Hexaware introduced a global delivery model, offered consulting on technology upgrades, and established a center of excellence to streamline collaboration between front-end and back-end teams. By implementing these strategies, the client achieved increased efficiency and stronger operational alignment, and transformed patient satisfaction.
