Case Study
Insurance Discover
Cost Avoidance Strategy with Accenture Saves $702M for Large Medicaid Program
Business issue
A large Medicaid plan managed by Accenture has historically used monthly health plan eligibility reports to cross-check its member list and identify additional insurance coverage. The data matching process is not only inefficient, it’s also costly. Pay-and-chase recovery rates are 10% to 20%, at most. Plus, there’s no way to quantify how many additional insurance policies never hit the radar at all.
Background
Medicaid Program fee-for-service population has declined in recent years
Cost avoidance savings continue to climb regardless of volume of lives covered
Fee-for-service claims were appropriately billed to third-party payers through identification of other insurances and data maintenance
Solution Highlights
Significantly reduced administration burden and increased member satisfaction
By identifying other health coverage, the payment responsibility is routed appropriately avoiding overpayment and incorrect billing
Insurance Discover is the only technology in the market to continuously maintain data integrity
Customer Overview
Large state Medicaid program
Operations managed by Accenture
4.5 million members
Revenue management without limits
FinThrive provides smarter, smoother revenue management to 3,250+ healthcare providers in North America, including 37 of the 40 largest hospitals and health systems in the U.S.