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 Implemented Salesforce for a Leading International Organization Case Study
Case Study

A Leading Healthcare Company in the UK Transforms Operations with Datamatics Provider Book of Record (PBoR) Solution

Client

The client is a leading international healthcare company headquartered in the UK, serving over 38 million customers across the world. They also provide health provision services and operate clinics, dental centers and hospitals in many other countries markets.

Industry

Health Insurance


Region

Europe

Provider-Book-of-Record-PBoR-Platform

Challenges

The client being from the insurance industry, was facing significant disruptions due to the evolving digital landscape and was under constant pressure to deliver better customer experiences and services at every touchpoint.

One of the major challenges faced by the health insurance industry is the lack of a comprehensive solution that covers provider management, contract management, claims verification, and payment management.

Solution

Datamatics' Provider Book of Record (PBoR) is a cloud-based framework that automates provider onboarding, credentialing, and contract management processes.

It provides real-time connectivity with multiple systems, including Policy Administration, Pre-Auth & Claims Management, Rules Engine, Provider Portal, and Finance systems. It is built on Dynamics 365 Service module and is customized to provide contract management and claim validation features.

Impacts

cc198

0% leakage of claim

Over payments resulting from incorrect procedure pricing

cc64

90% reduction

On contract and rate validation time

cc90

30–40% reduction

In claim processing time cycle

cc85-m

50% reduction

In credentialing time

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