Case Study

Case Study

New EDI process speeds onboarding

  • Insurance

Adeptia’s solution freed up IT experts, empowered business analysts and gave company power to scale up

About the Company

Industry: Insurance case management focused on patients with complex and catastrophic injuries and diagnoses.
Employees: 700

Benefits

  1. Reducing IT Workload:
  • With Adeptia’s ease of use and faster implementation process, less maintenance was required, meaning less involvement from IT.
  • Adeptia’s tracking empowered business analysts to handle EDI troubleshooting.
  1. Faster Customer Data Onboarding:
  • Adeptia enabled to company to reduce its onboarding time by two-thirds, from 45 days to just 15 days.
  1. Ability to Scale:
  • With Adeptia’s onboarding solution in place, the company was able to process more than 100,000 bills per month and scale 20 percent year over year.

The Challenge

Before Adeptia, the company company seeking replacement for their current EDI processing solution, which was an inherited legacy system. The system used a highly specialized, customized process for healthcare billing that had a high error rate and required too much work by IT employees to maintain.

The company was struggling to onboard new clients, taking an average of two months to complete the process. Besides the delays in integration customer data, the time-consuming onboarding work pulled the company’s IT developers away from other projects and initiatives.

The developers were hamstrung by a clunky deployment process and with a rudimentary mapping system that had no baseline mapping ability, as well as limited code re-use, resulting in even more work for IT.

What’s more, the company was unable to bring on new customers quickly, taking an average of two months. Though the company anticipated an annual growth rate of 20 percent, and projected its monthly bill volume to increase from 255,000 to 322,000 by year’s end, the system they were relying on was unable to scale. Parsing large files with more than 1,000 bills took the company hours.

Partnering with Adeptia

The company first contacted Adeptia in April 2021 because they were seeking an EDI software solution, first referencing Gartner, then finding Adeptia from another EDI Market Source. The contracts were signed in Aug. 2021. Adeptia addressed the company’s pain points by delivering performance improvements that resulted in platform stability, scalability, and reliability. Ease of use and speed of implementation was improved, making maintenance easier, and requiring less IT involvement. Also, tracking at all levels, including file and bill level, was enabled, allowing EDI troubleshooting by the business analyst team.

The Business Value

Thanks to Adeptia, the company was able to:

  • Reduced Operational Expenses (OPEX) by 25%.
  • Reduced Onboarding Time from 45 to 15 Days.
  • Processed Over 100,000 Bills Per Month and Scaled 20% Year-Over-Year.
  • Ran Up to 30% of All Business Flows Through Specialty Business, Enhancing Scalability.
  • Fast Forwarded Revenues by 2 to 3 Months, Ensuring Platform Stability and Reliability.
  • Reduced Support Hours by 25%, from 8,000 to 6,000.
  • Reduced Alerts from 1,800 to an Average of Just 50.
  • Improved Service Levels to Enhance Customer Retention.
  • Freed Up IT Time to Launch New Product Lines, Enabling Business Users to Handle Onboarding.
  • Reduce the number of support hours by 25 percent, from 8,000 to 6,000
  • Reduce the number of alerts from 1,800 to an average of just 50
  • Improve service levels to improve customer retention
  • Free up time for IT to launch new product lines (because business users handle onboarding)

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