With the rise in operational complexity across many healthcare payer environments, improving productivity with an efficient end-to-end process is crucial to controlling costs and errors, reducing duplicate effort, and minimizing ineffective work-arounds—all while improving the member and provider experience.
Firstsource’s Business Process Automation services are designed to identify the root cause and effect of operational impediments, then recommend and implement automated solutions that make your process streamlined and scalable while maintaining optimal performance. Our experienced team uses our Sympraxis® Business Process Management platform which combines automated workflow, robotic process automation (RPA), machine learning, artificial intelligence, OCR and data mapping tools to integrate applications and platforms, and create a user-friendly interface across multiple, discrete systems. The result is reduced human error, faster processing time and improved process efficiency leading to reductions in over payment, appeals and grievances, and increased member and provider satisfaction.
An improved member and provider experience begins with analyzing the cause of issues and optimizing staff productivity in relation to the customer journey. After gaining a thorough understanding of member, provider and user interactions and behaviors through journey mapping, Lean Six Sigma analyses and, where appropriate, our First Customer Intelligence (FCI) analytics solution, we identify opportunities to reallocate tasks, minimize the potential for human error, and maximize efficiency. From there, we devise a scalable, streamlined business process automation solution that automates the process as much as possible to make it highly effective, replicable and adaptable, ultimately helping members make informed healthcare decisions while reducing turnaround time (TAT).
Using Firstsource’s Sympraxis® Business Process Automation platform, we provide an end-to-end workflow management and digital solution across multiple business processes and locations. By standardizing and triggering event-based workflows driven by specific business rules, payers are empowered by simplified processes, reduced costs, and faster response to requests. “Standard Operating Procedure” analysis and re-design also enables us to deliver greater visibility and insights into operational efficiency and potential obstacles, helping to continuously improve processes.
Our horizontal business capabilities enable us to quickly customize workflows across multiple lines of business as well as integrate these workflows seamlessly with enterprise data centers and third-party tools. By connecting and streamlining fragmented processes, Sympraxis helps to enhance business agility and responsiveness through a configurable deployment model that ensures rapid implementation.
Analysis is an important step toward identifying improving efficiencies, enhancing service and reducing costs. We start by conducting a benchmarking study of existing processes using a Quality Function Deployment (QFD) tool and Six Sigma tools to drill down into the root causes of problems and inefficiencies. We also perform a time and motion study and prioritize recommendations based on ease of implementation, permanence, stakeholder impact and cost factors, helping you to resolve common process impediments and reach key objectives such as: