Case Study

USA Based Attorney Processes 400 Medical Claim Files Every Month with Precise Claim Processing

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Transaction Processing at Backoffice Pro (BOP)

Backoffice Pro (BOP) is a renowned data processing company in India, assisting global insurance companies in their insurance claim processing, transaction processing, form processing, and various other requirements. We are then trusted partners for the organizations owing to our precision, quality deliverables, and competitive rates.

Meet the Client – An Attorney in the USA

The client is a US-based attorney dealing with medical insurance.

Objective Behind the Data Entry Project

The goal was to convert the claim form documents and patient reports and analyze them for later usage.

SYNOPSIS

Country

USA

Software / Application

Client’s Proprietary Software

Volume

400 files per month

Client’s Challenge with the Claim Processing Requirement

The client required outsourcing back-office requirements. The outsourcing partner needs to analyze the case histories and later answer the defendant question of verification if required. The job involved working with claim forms and patient reports.

Claim Processing Solution at BOP

To begin with, we decided to discuss with the client in detail about his requirement and clarified all our doubts for both the client and us. Among the issues addressed were turnaround time, security, error-free upload, and the pricing structure. We went for an instrumental trial session that helped us to grasp the intricacies of the project.

To start converting legal documents, we set up a VPN to work on the client’s server. The client also put in place software that would allow us to get access to his files, prioritizing the security of all transactions at every stage with his approval.

We addressed all quality issues systematically with daily monitoring. Particular attention was paid to issues like index numbers, dates, exhibits, and client verifications. To further ensure the integrity of all information and its quality, we established a webchat system with a verifier in the client’s US office.

Once we had all the required information, it was be incorporated into the relevant document and sent to the client. At this step, too, we deployed a quality manager to oversee the final document. This would later be downloaded, printed, and verified by the client. The client was always kept in the loop so that any document could be removed or uploaded in time.

The client’s legal expertise lay with medical insurance, due to which the requirements seemed complicated due to the legal terminologies used. However, our drive to learn, and our quick response time impressed the client.

Claim Processing Project Outcomes

The result was a tremendous improvement in quality, receiving high praise from the client.

Productivity jumped to 400 files per employee per month.

The client’s satisfaction with our service is attested by awarding us to manage his entire document processing.

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