Case Study

Rural Sourcing Helps Leading Dental Insurance Provider Cut Costs and Improve Data Integrity

the challenge

One of the leading dental insurance providers in the country was struggling with data integrity. Each client they worked with, whether it was a large insurance provider or a local dentist’s office, would send them large amounts of patient information. All of this data had conflicting formatting, which slowed the claims process down, putting the client at risk of government-imposed fines, and made it harder for them to process claims correctly, resulting in over and under payments.

solution

This client receives both a steady stream of data every day, as well as a large influx during open enrollment. In order to help them operate more efficiently, we split our colleagues into two separate teams to help this client manage their data, and provide extra support leading up to the launch of their proprietary solution: Tritium and Elevate. Tritium handled all of the member enrollment and data migration tasks. These colleagues would implement BizTalk policies to automatically allow client files to process correctly each time an anomaly would appear. Elevate acted as triage, handling any help desk tickets and data clean-up. Both teams used extremely detailed SQL queries to manage and update millions of rows of data at a time, ensuring complete data integrity.

 

results

The Tritium team handled 357 complex ticket inquiries in the first year, and that number has increased 10-15% each year since, providing much-needed efficiency to help the client avoid government-imposed fines. The Elevate team’s ad hoc scripts were incorporated in a tool that allowed the client to complete redundant tasks on their own, which in turn helped the client operate so efficiently that they eliminated the need for one FTE on this project.

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