Case Study: Healthcare
Improving cash flow collections by more than $35 million annually
Increasing propensity to pay, reducing loss ratio, streamlining labor costs, and dramatically improving provider abrasion for leading payer
Sagility account leadership refined focus beyond collections to planning and forecasting. We created and piloted an analytics model focused on less than 90-day (within client collection window) claims overpayments. With this data mining by age of receivable, we earned client trust to build another model that delves deeper into overpayment costs, recoup, and forecasting. This more mature and client-aligned model collects and forecasts provider collections and overpayment data to increase per-day savings and determine solutions by weighing against overpayment volume, to address amounts owed to client, by provider. This model calculates interest on overpayments and flags possible escalations.
Today, Sagility provides the power of several thousand FTEs across 11 facilities and 5 countries (India, Philippines, United States, Jamaica, and Colombia) to the payer. We manage more than 95 separate processes for the client, across voice, non-voice, front office, back office, fulfillment, and knowledge management. The client trusts Sagility with a wide scope that spans medical, dental, life, vision, LTD, STD, pharmacy, and worker’s compensation across Medicare/Medicaid groups and commercial plans.
With this days-sales-outstanding (DSO) model focused on receivables age, interest, and day-window collection probability, Sagility has tightened up the loss ratio for this client, to reduce leakage and free capital of more than $35 million.
With Sagility’s precise focus, financial recovery forecasting accuracy has improved from 80% to 95%. The uplift in recovery results from faster payment turnaround time and more pragmatic overpayment process focus. Annualized predictions will yield increased cash flow in the future.