- Digital Transformation
- Business Process Transformation
Our client administers a government health insurance program that combines government healthcare insurance and approved private health insurance carriers. The client was challenged by years of poor funding and was using outdated, manual claims adjudication processes that in some cases were taking three years to fully investigate, approve, and make payments to providers. No formal business rules or process documentation was in place as the department was understaffed, lacked any capital for innovation or improvements, and additional resources were costly.