Workers' Compensation Provider Revamps Billing Processes

As the leading workers’ compensation provider in the state of Texas, this Genus customer insures 40% of the Texas workers’ compensation market. More than 62,000 business owners rely on them to meet the needs of 1.3 million workers every day.

To provide exceptional services, the company relies on a great workforce and innovative technology systems. However, when a long-term technology provider announced that one of these systems would be phased out, finding a new and better solution became a top priority.

CHALLENGES AND GOALS

When the leading workers’ compensation provider in the state of Texas heard that their legacy workers’ compensation billing system was going out of support, they knew that replacing it would require great effort. They also recognized that this challenge represented an opportunity to use newer technology to become more efficient.

With this in mind, the customer vetted three companies to find the one best suited to provide the expected level of functionality while meeting five new objectives:

• Simplify workflows
• Improve the end-user experience for the data and document capture group
• Reduce system complexity
• Ensure high reliability and availability
• Deliver top-notch data and character recognition performance

SOLUTION

Three competing options emerged from preliminary research into alternatives. Following a call for proposals, Genus Technologies presented a highly detailed plan documenting how Tungsten Automation (formerly Kofax) technology would uniquely address the organization’s objectives.

During subsequent discussions and demonstrations, Genus Technologies convinced the search team that its solution, powered by Tungsten Automation software, provided distinct advantages the other vendors couldn’t match.

Results

Working with Genus Technologies to implement the Tungsten Automation-powered solution, the customer achieved their objective of maintaining uninterrupted workers’ compensation billing, while gaining the following results:

• Eliminated extensive custom programming and related services during implementation by selecting a competitively priced, configurable solution.
• Simplified workflow based on staff needs rather than on the capabilities of the particular software product.
• Increased visibility into the effectiveness of the capture system with simple dashboards and robust analytics.
• Improved the extraction of critical data from UB-04 and CMS-1500 documents.
• Deployed a greatly improved user interface in terms of ease of use, visual clarity, and customization simplicity.
• Increased workflow efficiency by pointing documents to the right people so bills could be processed efficiently with as few people touching the bills as possible.
• Ensured CPT codes were always accurate, reducing processing time and resource allocation.
  
  

"The medical billing process is organic and it changes over time. You need to pay attention to that. Tungsten Automation and Genus Technologies gave us tools for doing that."
– Senior System Analyst, Major Workers' Compensation Provider

SUMMARY

As the dominant workers' compensation provider in Texas, with a 40% market share, this Genus customer serves over 62,000 businesses and 1.3 million workers daily. Their commitment to providing exceptional services relies on a skilled workforce and innovative technology systems. However, when their long-term technology provider announced the phasing out of a critical system, they faced the challenge of finding a superior replacement.

The company embarked on a search for a solution that not only replaced the legacy workers' compensation billing system but also leveraged newer technology to enhance efficiency. After vetting three potential companies, Genus Technologies emerged as the ideal candidate, presenting a detailed plan that showcased how Tungsten Automation technology would uniquely address the organization's goals. 

Through the implementation of the Tungsten Automation-powered solution, the customer achieved uninterrupted workers' compensation billing, eliminated extensive custom programming, simplified workflows based on staff needs, increased visibility through user-friendly dashboards and robust analytics, and improved data extraction from critical documents. This deployment also offered an enhanced user interface for clarity and customization, improved workflow efficiency, and ensured accurate CPT codes, reducing processing time and resource allocation. This strategic move not only overcame the challenge of system phasing out but also delivered substantial benefits to their operations.