Case Studies

Client Profile

A global leader in specialty home medical equipment with a sales force that services thousands of medical practitioners and patients. Products include:

• High-end medical devices that require verification of insurance benefits and pre-authorization for the submission of complex medical claims
• Specialty medical devices involving high volume of claims.

Service centers onshore and offshore work jointly with patients, physicians and client sales force to ensure seamless delivery of services.

The Challenge

To grow profitably, the client wanted to improve cash flows by optimizing its revenue cycle. The client selected SCUBE SYSTEMS after a rigorous evaluation process. The key factors for selecting SCUBE SYSTEMS were: Domain expertise and experience in the healthcare sector; superior analytical capabilities; and commitment to excellence. The processes offshored to SCube Systems Include:

• Sales order processing and support
• Healthcare billing and collection from insurance carriers and patients

The SCUBE SYSTEMS Solution

• Risk-based rewards and penalties to align the SCUBE SYSTEMS team with client outcomes
• Continuity of bridge teams and functions
• Ability to continue with existing systems and develop bolt-on tools
• Augmentation of capacity to handle certain areas of business that provided opportunity for incremental collections
• Specific analytics to allow teams to prioritize claims with a greater likelihood of being paid. Creation of comprehensive review systems to facilitate better coordination and focus among teams
• Systems for monitoring and improving process quality and capabilities
• Implementation of governance-based solutions to manage the client’s internal stakeholder support and communication, as well as oversight of plan implementation.

Extending Your Enterprise

SCUBE SYSTEMS extended the client’s enterprises by transforming its revenue cycle operations, thereby increasing collections, accelerating cash flow and improving customer service while lowering costs.

Benefits delivered by the SCUBE SYSTEMS team

• Increased Collections
  • SCUBE SYSTEMS committed to a specific collections increase
  • SCUBE SYSTEMS established an analytics-driven collections strategy
  • Process re-engineering, technology enhancement and modified work plans helped increase collections by four percent.

• Improved Velocity and Visibility
  • Overall accounts receivable days reduced by 15 percent
  • SCUBE SYSTEMS dashboards created significant visibility into detailed lead indicators and drivers. They also improved management controls and decision-making.

• Reduced Costs
  • SCube Systems Increased staffing by 25 percent, yet the total operations cost reduced by 25 percent.

• Retention of Key Resources
  • The client was able to retain a high percentage of the client’s management staff, post the outsourcing relationship with SCUBE SYSTEMS.