MEDCONNECTIONSM HELPS INCREASE PHYSICIAN PRODUCTIVITY THROUGH AUTOMATION

GROUP INSURANCE - PHYSICIAN ANNOTATION OF MEDICAL RECORDS

Background

The client is one of the largest life insurance companies in the U.S.A.

EXL physicians in India support client physicians in the U.S.A. for decision making on long-term disability claims. EXL physicians review claim history, medical, records and related documents to create chronologically structured annotations for client physician decision support.

Context

CHALLENGE

  • Indexing and annotations accounted for taking up ~75% of client physicians’ time
  • Client physicians spent a significant portion of their time on non-value adding tasks, including reviewing unstructured medical records, deciphering illegible hand-written records, non-medical correspondences, identifying duplicates, and other issues
  • External files were reviewed by US-based physicians when volumes were high
  • These issues led to longer claim turnaround times

THE IMPACT OF THESE ISSUES

  • Less time was spent by highly skilled physicians on their core tasks
  • Increased cost of operations

Orchestration

THE EXL SOLUTION

  • Developed a global delivery model that leverages EXL physicians’ medical domain knowledge
  • Automated indexing and annotation templates
  • Business insights on claim type, such as legal versus non-legal, and medical characteristics

THE EXL DIFFERENCE

  • Skilled medical experts for the process
  • Accurate, structured and consistent medical annotations
  • Took a lean operations approach for activity level control and measurement

Outcomes

A more streamlined approach enabled physicians to focus on positive outcomes for long-term disability insurance claims.

  • 50-60% Time savings per file review
  • 40-50% Reduction in cost of operations
  • ~$0.50M Cost savings
  • Improvement in claims cycle time

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