Moving to full outsourcing subrogation services delivers over $4M annual savings

Challenge

A large regional health plan partnered with EXL Health to co-source their subrogation services. In their initial model, the client identified cases and sent them to EXL Health via spreadsheets that did not include claims data. For their next model, the client provided claims, but not the identification.

After ten years of this co-sourced partnership, the client came to EXL Health looking for a change. They felt they were not maximizing recovery opportunities and wanted to reduce their workload and other party liability (OPL) full-time equivalents (FTEs).

Human ingenuity

Looking for EXL Health’s recommendation as a trusted partner, the client switched from co-sourcing to a full outsourcing model with EXL’s five-step end-to-end process: identification, investigation, case management, recovery, credit and reporting.

With efficiency as the highest priority, EXL Health worked with the client to maximize gains in the workforce proficiency. EXL Health partnered with the client to implement a hybrid global delivery model with a customized solution so that certain case types and data were only handled in the US, per regulatory requirements.

Prior to fully outsourcing the OPL and subrogation responsibilities of client, the tasks that the FTEs were completing were time and labor intensive. Non OPL resources were also required to assist in non-core tasks, such as mailroom, clerical, or other duties. By fully outsourcing their subrogation needs, the client’s FTEs were reduced by 50% and redeployed within the company, and non-OPL resources were no longer needed. Their remaining staff was able to transition to more substantive duties. The client described the efficiency gains as “extraordinarily positive”.

Outcomes

  • 50% reduction in FTEs, who were redeployed within the company and transitioned to more substantive duties
  • Non-OPL resources were no longer needed
  • +50% increase in client recoveries, from a low of $2.8 million prior to full outsourcing to a high of $4.3 million annually
  • $4,178,601 average savings per year 2018-2021