The challenge

A leading health insurer had a large backlog of physician reports that needed correcting to stay compliant and avoid fines. They included escalated cases where the change request was already ageing or had been changed multiple times, cases where mistakes had been made by associates, reports with incorrect physician information, and claims challenged by patients.

Without the necessary bandwidth or resources in-house and with set targets to correct the reports, the insurer needed to engage a trusted partner that could bring its report backlog up to date quickly and efficiently.

The solution

TTEC deployed an agile, dedicated team to manage the backlog in record time, introduce quality control measures, and ensure ongoing compliance. TTEC quickly put in place an experienced team that was rapidly trained to use the client’s back office system to modify and resolve the reports. Associates were trained to manage both voice and non-voice interaction volume to maximize resources and resolve reports more quickly.

TTEC devised new audit and process flows to ensure accuracy of work, which was adopted by the client. The team brainstormed twice a week to ensure continued accuracy and to add value to the development and enhancement of existing processes.

The team also instituted daily progress reports to allow visibility into the activity and track progress. At one point, TTEC noticed that report volume suddenly slowed substantially and alerted the client. It was discovered that the bulk of the reports had not been fed into the automated data feed, resulting in a renewed backlog. TTEC worked tirelessly to bring the reports back up to date again.

The results

Within three months the backlog of 70,000 reports had been cleared and the subsequent daily receipt of 1,000 reports could be processed in near real-time. TTEC continues to produce 11 cases per hour against a goal of six, 83% above target productivity goals.