Case Study:
Productivity Surge: 271% Growth in Claims Handling
Explore how DME Service Solutions revolutionized claims operations for a leading Remote Patient Monitoring provider, dramatically boosting processing capacity while upholding quality standards.
The Client
Our client is at the forefront of the Remote Patient Monitoring industry, providing critical personal emergency response services. Amidst swift market expansion, they faced the complex challenge of scaling their claims processing capabilities while preserving their standards of patient care and service excellence.
The Challenge
Scalable Claims Processing: Amid rapid growth and increasing demands for reliable patient monitoring, the client’s existing claims processing infrastructure struggled to keep pace. The challenge was significant: manage a growing volume of claims without sacrificing the essential quality of service that emergency response systems require. Recognizing this need, the client sought a scalable and efficient system capable of accommodating increasing numbers while seamlessly integrating with existing operations. This adjustment was crucial to maintaining the integrity and reliability of their services, optimizing workflows, reducing response times, and ensuring that patient care remained effective and uninterrupted.
The DME Service Solutions
Targeted Incentive Strategies
Strategically instituting an incentive program at no additional cost to the client, agents met the claims processing targets within the first month. This approach not only cultivated a competitive yet collaborative atmosphere but also ensured agents were fully engaged and aligned with operational goals. This targeted strategy improved the overall efficiency of claims handling, reinforcing high service standards.
Adaptive Performance Calibration
Implementing weekly calibration sessions across all teams, the company effectively synchronized claims processing practices with the nuanced demands of patient monitoring. This strategic alignment allowed for the rapid identification and swift resolution of productivity bottlenecks. This proactive approach ensured that operational efficiencies were continuously optimized, maintaining high standards of patient care.
Enhanced Agent Onboarding
DME instituted a custom onboarding process specifically tailored to the client’s unique requirements, designed to swiftly reduce the learning curve for new agents. This strategic enhancement in training methodology consistently boosted claims processing volumes each month. The clear link between improved training practices and operational performance was evident as agents efficiently handled increasingly complex claims scenarios.
Quality Assurance Protocols
Implementing QA measures, DME adapted to the rapid expansion in claims processing by ensuring that high quality standards remained consistent. These advanced protocols were essential in preserving the accuracy and integrity of each claim. By continuously monitoring and refining the claims process, the company maintained pace with increasing volumes and enhanced the reliability of its services.
Continuous Knowledge Growth
The Process Knowledge Test, central to the development strategy, assessed agents’ understanding of the nuanced RPM processes. By continuously updating and refining the training content based on PKT outcomes, DME not only deepened agents’ understanding of the processes but also enhance the team’s problem-solving skills in real-world scenarios. As a result, resolution times decreased significantly, boosting the team’s overall throughput.
Iterative Process Advancements
Our approach emphasized continuous process evaluation and adaptation, enhancing claims management workflows and operational efficiency. By identifying and addressing inefficiencies, and implementing new technologies, we ensure a more robust and responsive claims processing system. This resulted to swift adaptation to increasing demands and complex challenges, maintaining high service standards and promoting ongoing operational improvement.
The Result
131%
Average % to goal in 9-month period
271%
Improvement In Productivity, 9-Month Period
100%
Goal attainment in Month 1