No Surprises, No Delays: Streamlining Healthcare Disputes
Georgia Green, Executive Director of Service and Operations for NSA (No Surprises Act) disputes at a leading U.S. health insurance provider, was confronted with escalating challenges as her team struggled to manage rising dispute volumes and adhere to tight negotiation timelines. A backlog of 14,000 cases and significant revenue implications underscored the urgency for intervention. Turning to long-time strategic partner, Infosys BPM, she initiated a transformation. This case study highlights how Infosys BPM rapidly scaled her team within four weeks, eliminated the entire backlog and cut turnaround time by 50%—all while maintaining a quality score above 98% and ensuring zero missed disputes.
Approach summary:
- Ramped up resources within 4 weeks.
- Implemented cross-training programs for quicker learning.
- Created a strategic burndown plan for proactive resource planning
- Distributed workload across onshore and offshore teams
- Conducted internal quality audits
Key Benefits:
100% of backlogs cleared 
98% quality score maintained 
>50% reduction in overall TAT 
Zero misses or flips on disputes 
