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MILLION MEMBERS accent ure. Shifting to a more consumer-focused landscape Millions gaining health insurance – thriving with Kaiser Evolving Care Delivery Advancing technology in improving quality and efficiency Internet of Things and AI/ML Faster claims Settlements and payments Sustainable governance and Environment.
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76 Continuous Improvement Tools since 2015. Modernized claims platform for affordable health care.
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Business users spending more time on non-core activities IT Operations not designed to improve business intimacy No agility & industrialization in maintenance & monitoring of business operations Federal mandates to improve convenience in patient care and reduce overhead costs Higher lead time for QA causing increased complexity in deployments High License cost for third party tools in archival, Robotic process automation Redefine HealthCare Data Xchange Zero infrastructure failures & Swift claims settlements Zero backlog on customer benefits and payment explanation Efficiency in IT Operations Deliver Values to Business Improve Experience.
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How Accenture helped to deliver Client expectation??.
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Intelligent Problem Management: Implementing Smart Sense Automation: Hyper Automation API automation Service Virtualization Low Code-No Code Intelligent Operations Intelligent Operations Business Intelligence Elevated Experience Business Value Initiative Modernize Claims Settlement Landscape Innovation: Defined Innovation Framework through OPERA and Maturity Assessment Sustainable solutions / utilities for affordable care Implement Microservice based REST full webservices Real time monitoring Pattern based and Predictive observing BOTs powering Tapestry Claims Processing Scientific approach/Experimental refining for faster deployment.
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Industrialized Process Smart Tool Accelerator Established RPA COE Hyper Automation IT Landscape Talent Management.
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Govt Federal & Industry Mandate. Business Challenges & Aspirations: High license cost ($13.5 M/Year) of legacy archival system for Claims supporting documents Portability issue of different file formats between claims supporting documents and CARS (Common Archival and Retrieval system). Unavailability of any existing system to provide an overall view of Claims along with supporting documents and Clinical data/images.
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Industrialized Process. Smart Tool Accelerator. Established RPA COE.
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Industrialized Process. Smart Tool Accelerator. Established RPA COE.
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Industrialized Process. Smart Tool Accelerator. Established RPA COE.
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Industrialized Process. Smart Tool Accelerator. Established RPA COE.
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Epic Certified 22. Epic Proficient 29. Industrialized Process.
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ELEVATING VALUE AT EVERY STEP.
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Em—Nt— . O Task Automation Simple Automation O automation Tot O Business Operation (Eoe , EOP. Ui]Path Qai AUTOMATION 3600 value FHR [Oilpath smilecæ KPCC JOURNEY TOWARDS HYPER AUTOMATION O Event O TEST SCOPING ARCHIV AL AND RETRIVAL m arehwal @1mn day in HE TERCX3ENOUS DATA TO CONVERSION Records O SMART SuRT SuRT RPA IN PRODUCTION CLAIMS $6Mn effort -38 KP FTE efforts CLAIMS SETTLEMENT ENVIRONMENT MONITORING IOS • n Claim Settl—t vity Elimination of 99.1%in Eoe EOBs/min.
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15. Accenture partnered with Kaiser in Payer and Claims space in solution, design, development, environment setup, testing and release management. KPCC SME capabilities range from providing insights for specific business problems with next gen technologies to scaled, repeatable, cost-effective delivery via enhanced methodologies for design and technology-based solutions leveraging onshore – offshore model..
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Appendix.
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76 Continuous Improvement Tools since 2015 Modernized claims platform for affordable health care Diamond Client for Accenture Technologies Support – Java, SAP BO, Tableau, DevOps, React JS, Node JS, Splunk, AI/ML, Kafka, Ready API, UFT, UI Path Zero SLA misses in 8 Years $300K cost savings through Automated Project/ Environment & Service Management tasks in FY21 $125K cost savings through process optimization/proactive maintenance in FY21 $320K savings through Automated Analysis, design, & build tasks in FY21.
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KPCC – Platform Modernization. Copyright © 2021 Accenture. All rights reserved..
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Industrialized Process. Smart Tool Accelerator. Established RPA COE.