The challenge
Signature Performance worked with its government client for more than 18 years. As its customer faced care access challenges, Signature Performance recognized that its claims system had to be modernized to ensure beneficiaries would have timely access to healthcare. Areas to address included the speed and accuracy of claims processing, reporting methodologies, compliance, security and administrative support. In the existing legacy claims system, only about 60% of claims were auto-adjudicated. That meant many of the client’s staff and contractors had to manually enter data that led to data quality issues, reworking of claims, a high volume of calls from providers and patients for assistance and increased administrative costs for the government client and ultimately, US taxpayers. Time- and labor-intensive backend processes also limited flexibility in allocating human resources to other high-value and patient-facing work.