[February 25, 2014]

Demand for OpenSpan Solutions Accelerates Among Leading National Healthcare Insurance Organizations

OpenSpan, Inc., a provider of innovative worker optimization, activity management and automation solutions, today announced a recent acceleration for OpenSpan (News - Alert) Desktop Automation solutions among leading national healthcare insurance providers within their contact center and back office claims processing environments. Focused on driving down the cost to serve within their contact center operations and minimizing processing costs associated with claims adjudication, these organizations are adopting OpenSpan's automation solutions to eliminate redundant, manual activities and streamline worker processes for greater operational efficiency and increased throughput.

Healthcare claims processing is an expensive and repetitive operation that costs the healthcare insurance industry billions each year. Despite investments in adjudication systems and other workflow tools, payers still process between 10 to 50 percent of all claims manually. These companies are turning to claims automation solutions like OpenSpan to increase first-pass adjudication rates while leveraging their existing technology investments. This results in a significant reduction in processing administration costs, compliance with Medical Loss Ratio (MLR) requirements, and an overall improvement in claims payment accuracy.

Using OpenSpan, one healthcare insurance provider was able to reduce its average claims processing time from 11 days to four, as well as decrease the number of cal inquiries to the contact center by 75 percent. Further, the provider was able to reduce the number of claims that were greater than 15 days old, which decreased prompt pay penalties by approximately 42 percent in the first year.

OpenSpan reports an increased adoption of its solutions among several leading national healthcare insurance providers over the last six months. "These healthcare insurance organizations face significant challenges when it comes to reducing their administrative costs related to the adjudication process," commented Rod Dunlap, vice president, insurance for OpenSpan. "As new regulatory requirements are mandated from the recently legislated Affordable Care Act, these organizations must be agile and responsive to changes to comply with standards as they are introduced. OpenSpan gives these companies the ability to rapidly drive transformation within their claims processing business areas while leveraging existing technology infrastructure."

In addition to optimizing claims processing business units, healthcare insurance providers are also focused on driving down the cost to serve in the contact center business units, but not at the expense of the member service experience. "Healthcare insurance member service is very different from a consumer customer experience in that it is a more emotional, private situation or circumstance," said Anna Convery, executive vice president of Strategy for OpenSpan. "Providers realize they must equip their employees with the tools to effectively handle all member interactions in a timely, thorough manner, and with the integrity and credibility expected to maintain a sense of trust and confidence."

For contact centers, OpenSpan Desktop Automation streamlines worker activity and eliminates the need for agents to navigate between complex systems and applications. Additionally, process automation enables these organizations to maintain compliance to industry standards like HIPAA. "Using an agile desktop environment powered via OpenSpan, these healthcare insurance organizations empower their agents to deliver faster, more accurate responses to inquiries, resulting in higher member satisfaction," added Convery.

About OpenSpan

OpenSpan is a provider of activity intelligence and desktop automation solutions that improve performance, drive revenue and increase efficiencies in contact center, back office and retail storefront environments. Activity Intelligence provides actionable, real-time activity and performance insight used to make informed decisions about people and technologies. Leveraging the critical insight from desktop analytics, organizations use desktop automation to streamline worker activity, simplify critical service processes and remove technology barriers as means to deliver a gold-standard customer experience. OpenSpan solutions are deployed on more than 300,000 desktops across the world, and are optimizing billions of transactions in the banking and financial services, insurance, telecommunications, retail and technology industries. For more information, visit www.openspan.com.

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