Case Study

Reducing Costs While Improving Injured Workers’ Experiences

Industries
Healthcare
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In late 2012, the client selected HG to design and execute a six-month pilot project to review medical bills. Through the efforts of a team of 12, HGS gained the client’s trust by showing proof of concept and demonstrating that processes could be successfully outsourced. HGS was able to exceed expectations in quality and productivity in only three months. By early 2013, HGS was engaged on a more permanent basis and the pilot project ended three months ahead of schedule.

The current team of 250 works with several client departments to deliver over a dozen distinct processes that touch injured workers, employers, and healthcare providers across the United States. HGS agents specialize in clinical and code reviews, case management, provider support and service, and data management, all to ensure claims are processed quickly and accurately and get injured workers back on the job as fast as possible.

With shared technology and training, performance dashboards, impromptu and scheduled meetings, strategic reviews, and site visits annually, HGS is truly an extension of their in-house team. HGS has developed stringent auditing and agent performance management techniques. These not only include Six Sigma and ISO quality management methods, but also regularly stratified work sampling, active monitoring of top error trends, and executing detailed action plans.

  • Savings of $41/bill (average) and $4 million (total) in nine months
  • $16,000 in savings per initiative
  • Exceeding 97% and 98% accuracy targets by achieving well over 99% and in India HGS is exceeding quality targets of 99%
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