EXL Robotics Solution – Experience making the difference

Client

Our client is a Medicare Administrative Contractor (MAC) responsible for reviewing millions of claims annually for the Centers for Medicare and Medicaid Services (CMS).

EXL solution

Automate searching, collecting and data entry from/to the mainframe using Verastream. Verastream instructions are written offline and then launched through web services. Mainframe systems are searched similar to an end-user but without any chance of error nor the time and cost of manual query.

Background

MACs like our client employ green screen mainframe applications to review, process and eventually approve or deny Medicare claims. The only method to interact with the applications is direct user interface—there are no web services or database connections available. Reviewers would manually copy data from the green screen mainframe system, paste it into the client’s homegrown platform; review the claim and then re-enter findingsinto the mainframe system. The impact?

  • Time-consuming and costly
  • Frustrating
  • High chance of human error

Results

  • Reduced review time by 40%
  • Staff performing nearly 2x as many claim reviews

Millions of dollars returned to the Medicaid Trust Fund

Contact US