Imagenet: Helping Healthcare Payers Beat the 'Great Resignation'

The need to digitize the end-to-end claim processing mechanism has been growing over the past decade but became increasingly more important during the pandemic due to the majority of the workforce working from home and the lack of force in the healthcare sector. During this time, health plans were under the same level of scrutiny to process claims in a timely manner while dealing with health and safety concerns in concert with ‘great resignation’. Fortunately for some of the payer organizations, Imagenet’s team’s expertise came in handy as the company was able to augment the workforce, provide digital and staffing solutions, and adapt to a newer reality.

“We’ve accomplished that through a couple of different means: we added our digital operations in the form of mailroom support, paper to EDI claims conversion, claims adjudication, as well as our contact center services,” says Patrick Smith, Chief Operations Officer, Imagenet. “These services operate 24 by 7, 365 days a year, providing our clients unparalleled access to technology processes and skilled resources.” The company provides digital transformation and BPO services to more than 250 payers across the U.S for their claims operations, mail rooms, workflow solutions and contact center services.

The clients call for help from Imagenet for a particular health plan, where Imagenet receives paper claims forms and medical records like X-rays, digitizes those documents, and returns electronic files to the clients. The clients can then automate the downstream processes, improve data analytics and develop a document repository that’s HIPAA compliant. In addition, the company provides claims adjudication services, where they will augment the workforce of a health plan using skilled adjudication resources. Imagenet trains the workforce on how to review the claims, properly pay them and provide appropriate denial or rejection reasons using their in-house proprietary technology. The company also provides reporting and analytics on financial and procedural accuracy to its clients. Finally, from a customer support perspective, Imagenet furnishes solutions using a cloud-based elastic call center, which can be easily scaled leveraging resources across the U.S.