You realize how good something is, only when you get a chance to work on it. As we at Intelegencia did, when a leading healthcare benefits management organization from the Middle East approached us with a problem which they thought only we could fix, given our expertise on Tableau as a premier process engineering company.
Our client offers support to insurance companies, mutual funds and large employer schemes with highly advanced tools and services such as underwriting & policy administration, providers’ network management, approvals & claims processing, settlement to providers and reconciliation, customer services and business intelligence services.
Fully aware of the evolving needs in the Pharmacy Business Management (PBM) domain, the company offers a complete standalone PBM solution designed to improve the value of pharmacy benefits plans. Moreover, it provides innovative and comprehensive services to manage its clients’ complex needs such as actuarial and international health services.
With operations in more than 14 locations, the client was finding it very tedious to handle data and create reports manually. A need was felt to have the entire process automated, possible only with the help of a renowned process engineering company such as Intelegencia through its global quality engineering services. Our client wanted to enhance existing CRM reports to improve the performance of the Dashboard and also add new functionalities to the existing CRM dashboard. Additionally, there were other major business risks that had to be looked into such as marketplace competition, timing and possible negativity that could affect it adversely.
Intelegencia’s Tableau experts answered this challenge on version 2018.3, showing exactly why the company has been so successful with its global quality engineering services. Claims Quality Assurance, Revenue Claims Management and Customer Relationship Management were the three processes implemented on the dashboard. Since the client was handicapped with measuring Key Performance Indicators (KPIs) manually, our team implemented these on the Tableau dashboard to help the client measure progress better. These were:
The newly created dashboard on Tableau 2018.3 now enables the client to calculate the entire claim amount and also net amount claimed from each Provider, as mentioned earlier that the client operates in more than 14 locations, on the basis of YTD, QTD, MTD, Service Category, Payer and Receiver. Going forward, the client will be able to compare the claims data with percentage value by each provider, payer and receiver. The newly created unified dashboard simplifies the entire process of understanding how the business works across all operational centers.