Customer driven processes: HCF utilises ReadSoft to increase productivity

REFERENCE THE READSOFT EFFECT ON HCF PROCESS: CUSTOMER DRIVEN PROCESSES INDUSTRY: INSURANCE STORY COUNTRY: AUSTRALIA HCF utilises ReadSoft to increase productivity By implementing ReadSoft software software, HCF have completely re-worked two key document pro- cesses, membership applications and medical claim processing. The result is increased efficiency and improved processing cycle times translating into de- creased operating costs. The challenge With the ever increasing volumes, HCF wanted to move their manual process of membership applications and claims to a fully automated process. The team not only experienced On an average day HCF receives frustration with the volumes received but also spent a large in excess of 2300 membership portion of their time attending to queries arising from man- documents and process 2000 ual processing. In addition to full-time staff members, HCF The Benefits medical claims per day utilized temporary staff each quarter to assist in processing Implementing the claims backlog. On an average day HCF receives in excess ReadSoft solution of 2300 membership documents and process 2000 medical has resulted in a reduction in the staff required to process claims per day with a predicted increase of 15% over a 12 medical claims whilst increasing the volumes of claims being month period. processed. This has enabled HCF to redeploy people within other units of the organization. Equally important has been The Solution HCF’s ability to significantly shorten the processing cycle HCF initially experienced the benefits of document auto- times. mation with ReadSoft when they digitized membership ap- plications for storage and retrieval. “We were planning for Increased efficiency and accuracy of claims have resulted in improved processing over the coming years and realized that a substantial decrease in claim rejection rates by Medicare imaging and automating our document handling processes (Australia’s legislative body) since the solution implementa- provided the increased efficiencies we needed”, comments tion. Statistics show over 50% reduction in Medicare rejec- Patrick Shearman, General Manager of Information Manage- tion rates, from 13% down to 6% . ment at HCF. The Results “Our objective was to find an automated solution for han- The implementation of the ReadSoft solution has been para- dling both the volume of claims received on a daily basis and mount in allowing HCF to streamline processes, shorten reduce processing time. It was a natural step to further in- cycle times and increase people productivity. “We see our- crease efficiencies from the ReadSoft solution into the medi- selves as ‘setting the trend’ in this area of our industry and cal claims processing area as well.” believe others will follow. The success of this project and the professionalism of the ReadSoft team has re-enforced HCF’s The ReadSoft solution captures and automatically integrates confidence to move forward with the next phase - automat- claims data into the existing medical claims processing appli- ing hospital claims”, said Shearman. cation, streamlining the process and eliminating manual key- ing in of information. About HCF The HCF Group, consisting of HCF and HCF Life, has grown to be A critical component to success was the implementation one of the largest private health insurance providers in Australia. phase and the ReadSoft consulting team worked very closely The Group provides health cover for over one million Australians with HCF to understand existing processes and future needs with 356,300 members also having HCF Life Insurance policies. prior to implementation to ensure a smooth rollout and tran- Established in 1932, HCF today has 871 employees and a turnover of sition to the new system. $880.5M AUD for 2007.