EDI Service Implementation

Teamwork Leads to Flawless Implementation

Situation Analysis and Customer Challenge

As a consequence of exponential growth, a nationally recognized leader in the health insurance industry was looking for a partner with broad industry experience and a deep understanding of the EDI process. They were counting on Vee Technologies to help resolve problems related to EDI and other services. The company had never outsourced any work in their 50-year history but knew something had to change in order to positively impact the market in ways never seen before. They had cutting-edge ideas, although needed the tools and resources to bring those ideas to fruition.

Client Objectives

The client was heavily loaded with a backlog of 8,000 claims (with a monthly volume of more than 2,000 in 2016). Once claims arrived, it could take 10 to 14 days to get them through their system. The company was posed to expect a 3- to 4- day turn-around from Vee Technologies, coupled with our industry leading accuracy rates of over 95%.

The Solution

Vee Technologies worked closely with the company’s project management teams to develop a well-designed rollout plan. That meant meeting regularly while keeping the client informed every step of the way. Given the project’s complexity and the sizable number of needed resources, the highly collaborative approach was central to the rollout’s success.

Vee Technologies conducted a test phase with the client and, with the questions that had been posed, the client realized they could do better by having Vee Technologies submit the files in such a way that they would go through with minimal manual intervention on the client’s end. Following a few case scenarios, the plan was put into action.

Within 90 days, Vee Technologies had effectively demonstrated to all levels of the client’s management team that we had the understanding and expertise to efficiently manage their unique claims processes. Currently their business has grown by 400% (i.e. approx. 8,000 claims/month). The client had access to not just one person or team, but all of Vee Technologies, including sophisticated collaboration tools, methodology, and ideas from more than 2,500 professionals across the firm.

Outcome and Results

With the confidence gained as a result of the success of partnering with Vee Technologies over the last 18 months (see chart below), the client engaged Vee Technologies’ advisory & consulting services for their on-line claims submission platform and have began actively transforming the way the company plans their future projects. With the expertise and process excellence that Vee Technologies has delivered, the thought of identifying and creating game-changing solutions is now a reality.

Outcome and Results

EDI Service Implementation - Teamwork Leads to Flawless Implementation

EDI Service Implementation - Teamwork Leads to Flawless Implementation