| Finance Dept. & Customer Service Dept. |
Financial Control over Disbursement Processing. Reduces Credit Risks. Centralizes Billing Data. |
UCDS provides for payment aggregation, scheduling and provider contract compliance. Improves EOB/RA communication to members and providers. |
BCBS Plan - UCDS aggregated payments from multiple claims systems and effectively documented payment information that resulted in a 50% Customer Call Center volume reduction and a redeployment of 40% of Customer Service Dept. personnel. |
| Operations |
An Enterprise Disbursement System that handles all Upstream Processing platforms |
UCDS normalizes all payment transactions from multiple claims systems, broker management systems, and other payment transactions. UCDS provides controls at business unit level and LOB, payment commonalities at an Enterprise level and post payment functions at a bank account level. Reduces Mailing and Check Issuance costs by 25% |
P&C Company - UCDS allows us to push payments output from over 20 different upstream worker comp, property & casualty and broker fee payment systems. Disbursement costs were reduced by 33%. |
| Compliance Dept., Audit Dept. and Provider Relations |
Regulatory/Contract Compliance & Audit Controls |
UCDS addresses State and Federal regulations compliance, surcharges, taxes and Fair Claim settlements. UCDS allows user defined criteria for audit file creation and systems claims "aging" a audit. |
BCBS Plan - Recent State regulations were placed into effect wit approx. 45 days prior notice. UCDS was configured in 2 weeks to perform accurate systematic calculations within the normal processing workflow. UCDS allowed for audit capabilities to demonstrate compliance accuracy. |
| Treasury Dept. and Portfolio Management Dept. |
Cash Flow Improvement |
UCDS provides extensive payment scheduling, cash forecasting, Prompt Pay adminstration and risk management. It increases investment funds and unpaid claims forecasts/cash requirements. UCDS centralizes bank account management. |
BCBS Plan- UCSD allows for accurate payment per Provider contract terms that improved cash investments and Treasury Management resulting in a return on investment of the UCDS systems in less than 8 months. |
| Operations, Finance Dept. and Provider Relations |
Better Output Information and Payment Cost Reduction |
UCDS aggregates payment and EOB/RA from multiple claims to specific provider maintaining a consistent payment document "look". |
BCBS Plan- Provider Service Dept. reconciles all payment output on-line and presents bowman information via the Web. Reduction in Fulfillment costs by 35%. |
| Operations, Claims, Treasury Dept. and Provider Relations |
Over Payment Recovery and On-Line voids and Re-Issues |
Industry averages show that over 20-30% of claims are disputed and adjusted, costing $30 / item to process. UCDS automatically adjusts the transactions on a line-item basis ad posts to G/L systems. |
BCBS Plan-UCSD reduced overpayment and allowed automatic adjustments to reduce retro recovery by 50%. The cost savings were estimated in the hundreds of thousands of dollars annually. |
| Operations, Provider Relations and Customer Service |
Stop-Loss, ASO / CDH Automation |
UCDS manages the need to bill and collect Cost Plus transactions and automatic fund fetching capabilities. UCDS perform Stop-Loss administration automatically and retains transactions electronically for data export or audit. |
BCBS Plan- UCDS allows multi-company Cost-Plus billing operations and Stop-Loss administration. Provides a competitive Marketing tool for better risk management and timely client communication. Promotes better information to all constituents. |
| Finance and Provider Relations |
Expand EFTProcessing and Web Reporting
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Industryaverages show costs of $4-$9 per printed document compared to approx. 30 cents per electronic transactions. EOBs and Remittance Advices can be presented on the Web for timely and accurate payment reconciliation. |
BCBS Plan- As a cost savings incentive to move to EFT, provider contracts has incentive provisions to submit electronic claims and received electronic payments. Adoption rate moved from 20% to over 60% in 18 months saving approx. $1.00 per submission. |