Faster claims processing and process automation
Care1st Health Plan Arizona, a Phoenix-based payer who provides healthcare coverage to beneficiaries of the Arizona Health Care Cost Containment System (AHCCCS) sought ways to improve how they imported data into their core system. A recent expansion into Pima County from Maricopa County took Care1st from an enrollment of roughly 50,000 to over 70,000 individuals virtually overnight. Line-of-business records, provider panels, and other records had to be added or updated quickly to ensure continuity of coverage and reimburse providers.
Additionally, as a newly-named Third Party Administrator (TPA) for Arizona’s insurance cooperative offered through the new National Health Insurance Marketplace (part of the 2010 Patient Protection and Affordable Care Act, or PPACA), the organization was preparing to handle potentially thousands of new enrollees and provider records over the coming months. In order to expedite this data entry, and reduce the need for frustrating macros, Care1st Health Plan Arizona turned to Nintex RPA to automate the process.