CHALLENGE
Medicaid and the Children’s Health Insurance Program (CHIP) provide medical coverage for more than 4 million low-income Texans. The state of Texas was terminating an agreement with their existing processing vendor due to breach of contract. The State of Texas asked Exela to provide paper processing of all claims, checks, prior authorizations, and provider correspondence. Given the critical nature of the above media, Exela was required to do a live cutover and process all 35,000 daily transactions on Day 1, while also meeting 8-hour turnaround times on some transactions. This meant there was no ramp-up time. Facilities, staff, and systems had to be fully in place, tested, and ready for go-live in order to maintain stringent service levels.
SOLUTION
Using careful planning and our proven implementation m methodology, Exela put a solution in place that utilized our Digital Mailroom platform. Sufficient processing capacity and accuracy were tested by running the system through a duplicate training set. This successful test ensured a seamless cutover of work. With a functioning, vetted pre-live capacity model, Exela was able to successfully go live on Day 1, processing 100% of volume as expected. In the following year, Exela service levels continued to trend on the positive side, resulting in improved turnaround time and a signifificant cost reduction for the state of Texas.
Benefits
- Reduced cost
- Improved turnaround time
- 100% compliance for check processing turnaround time
- 100% compliance for image quality
- 100% compliance for Prior Authorization 8-hour SLA
- 100% compliance for indexing quality