Taking a data-led approach to predict high-risk cases and prioritise action within the claims’ management process

BSG helped a leading healthcare provider to be in a position to save millions of Rands each month by making data-led decisions, enabling better prioritisation of action and reduction of claims-related issues

overview of the clients needs
  • Understand how to leverage data more effectively in the organisation
  • Become more proactive in identifying claims-related issues and prioritising action
  • Create visibility of high-risk cases within the claims value chain across the client’s South African operations
  • Take insight to action by implementing a data-led approach to solving the claims-related issues
  • Ensure implementable and measurable KPIs for the project
  • Use data and advanced analytics to provide insight into the primary causes of claims-related issues
  • Understand the impact on patient experience during the claims process
  • Prove the value of a data-led approach to the client’s executive team
  • BSG recommended and helped implement a pilot initiative to prevent claim rejections, which were costing the client over R40 million each month
  • The pilot initiative was driven by a machine learning model that accurately predicted inefficiencies in existing processes and provided insight into practical changes to drive business benefits
  • BSG followed a practical approach to operationalise the predictive model focusing on people, process and technology change considerations
enabling cost saving through data

BSG’s data-led approach combined multi-skilled teams, working with our client, to rapidly deliver implementable business change to drive cost savings and improve revenue collection efforts

Does your organisation know how to capitalise on opportunities that the future holds? Do you want to?

We have the knowledge and experience to support you to capitalise on the benefits that cloud based IAM solutions offer.

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saving the client an estimated R40m per month using dataimproving customer offers though data engineering and agile cross team collaboration