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
Insight-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.
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