Summary:
Faced with the challenge of transitioning their claims processing system in-house by a non-negotiable deadline, a prominent Florida health plan with over 80,000 members turned to SourcEdge for their expertise in AMISYS Advance. The project demanded rapid adaptation and expert execution to overcome significant operational and staffing hurdles.
Results:
- Achieved a seamless transition to the AMISYS Advance platform by the set deadline of January 1, 2023, despite considerable logistical challenges and a compressed timeframe.
- Implemented a holistic project approach encompassing assessment, reconfiguration, testing, deployment, and ongoing management, ensuring all aspects of the transition were meticulously handled.
- Significantly reduced the backlog of pending claims and customer service requests, improving operational efficiency and member satisfaction.
- Attained high auto-adjudication rates, enhancing the speed and accuracy of claims processing.
- Fostered a robust partnership with the client, laying the groundwork for future initiatives aimed at modernizing and transitioning their claims processing platform to a cloud-based solution.
