Amerigroup Boosts Productivity With Automated Workflows
Millions
90+
More
THE CHALLENGE
Disparate data sources and provider data quality issues
Transparency and trust between plans and providers are foundational to patient care. But without accurate provider data, as Amerigroup discovered, plans struggle to accurately validate claims and adjust risk, leading to revenue loss and member dissatisfaction. Navigating disparate systems to collect data from physicians placed undue pressure on Amerigroup’s Provider Data Management (PDM) team, slowing innovation, and impacting decision making.
BUSINESS NEED
Creating an integrated PDM system and single source of truth
Amerigroup needed a way to standardize data exchanges between external partners and internal systems, access data locked within departments, and build a single source of truth for provider identification, validation and data cleansing. Without an integrated PDM system, Amerigroup found it difficult to innovate and institute actionable change across the organization.
HOW OZ HELPED
Standardized data and intelligently automated the PDM system
OZ leveraged Intelligent Automation (IA) to integrate disparate systems and standardize data and reporting. Together with front-end development efforts, OZ achieved the following:
- Reduced inaccuracies from manual processes, saving millions in revenue
- Created a consolidated dashboard in real time providing a view of all existing data entry processes and requests within the PDM system
- Built a central repository of information from combined databases while maintaining the integrity of existing systems
- Provided the PDM team with a single source of truth for all the data
This new level of automation allowed Amerigroup to track requests processed by the PDM department—including the type and the number of open requests and glean average time to close requests—instantly.
IMPACT
More accurate claims, more savings
- Improved management oversight and a comprehensive understanding of every department’s workflows and status
- Millions of dollars in savings from the automation of over 90 processes
- Faster response times with the capability to monitor department workflows and employee performance
