CASE STUDY
Industry:
Health Insurance
Products / Services:
Membership management, Broker commission and AEP Simulation
Managing and transforming a leading Health Insurance provider based in East Coast USA
Client Background
Client is a leading health insurance organization and an independent licensee of the Blue Cross Blue Shield Association. With a mission to create a remarkable health experience, the company serves 7M+ members in East coast of USA.
Client Requirements
With large customer base, the client faced challenges in terms of member satisfaction and experience. The health plan required improvement in Star Ratings, attaining cost benchmarks, enhancing operational efficiency, and automating & streamlining the business processes.
Engagement Highlights
25+
% Reduced
Operational Costs
40%
Reduced Errors
during AEP
15%
Improved
Service Levels
Solution Highlights
With an aim to increase speed to market, our solution enhanced operational efficiency and improved Member experience. Member360 integrated into client’s existing solution enabling streamlined reporting as per CMS requirements.
Improved
Efficiency
Standardized execution practices and improved service levels across various businesses resulted in 90% increase in Operational efficiency
AEP
Simulation
The utilization of AEP simulation test environment led to anticipate issues in advance and mitigate any risk during AEP period
CMS changes &
Compliance
Provided 99% CMS transaction acceptance rate with no cost for CMS mandated changes
Transformational
Initiatives
Enabled to intake of multiple enrollment sources with user friendly Workflow system with queue based mechanism
Real-time
Reports
Provided near real-time reports and application status to plan beneficiaries, agents, sales reps, health plan operation teams for appropriate decision making
Multi-tenant
Implementation
Onboarded Client’s partners on Multi-tenant architecture solution with unified view
Automated and transformed the Membership management of a prominent Health insurer
Wipro provided an enterprise solution to handle both Medicare
and Medicaid memberships with a unified top to granular view of
the Membership financials.
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