Both voice and non voice processes were identified by the client for outsourcing. The non voice processes included the client’s medical billing processes i.e. Claims Data Entry, Claims Pre-Processing and Claims Processing (Adjudication) for Medical, Hospital and Dental claims. The voice processes included inbound customer care.

A phased solution was developed. Initially the three identified processes were migrate to India. A pilot team of 20 personnel including 15 process agents were trained at the client location to understand the complex processes. Members of this team would be responsible in training the batch of 300 FTE’s during the ramp up phase.

Some of the CPMs to be monitored are manual adjudication rate, % Claims Inventory, Productivity (Claims/Examiner/Week), Payment Accuracy- Large Claims, Claims Payment Accuracy, etc.