Using data to identify significant shifts in claims payment behaviour

BSG helped a leading hospital group save millions by enabling proactive identification of claims processing trends, resulting in early identification and resolution of issues. 

overview of the clients needs
  • Use data more effectively to proactively manage claim rejections
  • Identify adverse trends quickly to enable early corrective action
  • Regular monitoring to identify changes across the value chain that could lead to claim rejections by fund administrators
  • Understand underlying causes of shifts – both positive and negative
  • Provide automated, regular communication of significant trends and shifts
  • Recommend action to correct issues as they occur
  • Use data and statistical methods to monitor and measure potential impact of inaction
  • Prove the value of proactive monitoring to business leadership
  • Inform funder negotiations
  • Early identification of the most crucial issues to enable swift resolution
  • Reduction in bias in trends analysis through automation
  • Highlighting of key issues for resolution, resulting in faster, more proactive resolution
  • R18m reduction in short-payment rejections by a leading fund administrator over 7-months, resulting in a significant reduction in working capital costs and manual effort
Data Led Claim Rejection Trend Prediction Abridged
Over 650,000 trends analysed each week, helping to identify significant shifts in payment behaviour, reducing short payments by R18m in 7 months.

Are you getting the most out of your available data?

If not, let our data scientists and data engineers help you design an approach that ensures you get the most out of your organisation’s data, improving business productivity, cutting operational costs and improving bottom line.

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Legacy System Decommissioning AbridgedData Led Claim Rejection Trend Prediction