Workers' Comp

Unlocking Millions in Savings Through Optimized Medical Bill Processing

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Problem

A client was managing their medical bill processing in-house, processing over 80k bills a year. Despite their experience, they faced several challenges and recognized that their current process might not be yielding the maximum savings possible. They needed a solution to capture lost savings opportunities, reduce the number of FTEs required to process bills, improve turnaround times, and lower labor costs while re-assigning staff within the organization.​

 

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Solution

Enlyte stepped in to implement its advanced medical bill review service (TES). The solution offered advanced systems for thorough and consistent medical bill reviews, streamlined processes reducing the need for extensive manpower, and enhanced data analytics to uncover and capture savings opportunities.​ ​

 

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Outcome

Over four years there was a savings of $117.3 million in labor and medical cost savings. There was a reduction in full-time equivalents (FTEs) from 12 to 1.5. The average turnaround time was reduced from 6-7 days to 4-5 days, resulting in faster review processes that enhanced overall efficiency and patient satisfaction.​

 

 

Results After Outsourcing​

 

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$117.3M in total savings over four years with TES​

 

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Reduced FTEs from 12 to 1.5
Reduced turnaround time from 6-7 days to 4-5 days