Highmark Overwhelmingly Improves Customer Service And Productivity
Formed in 1996 with the consolidation of Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield, Highmark, Inc. provides health insurance services to nearly 7.4 million people in Pennsylvania and 18 million nationwide. The company is among the top fifteen insurers in the U.S., with annual premium revenues of $7.5 billion.
The Challenge
Highmark employees process an average of 25,000 claims (consisting of 200,000 pages), across all of the company's product lines, daily. While many claims are now received electronically, a large volume of paperwork remains, and must be quickly and accurately sorted and processed.
In 1996, Highmark decided to replace its twelve-year-old image processing system with a more technologically advanced solution. Kathryn Siburt, Manager of Mid-Atlantic Claims Review, knew the company needed a flexible, software-based system that could deliver faster processing with increased degrees of accuracy and reliability.
Highmark receives claims as single-page HCFA 1500 forms, many of which are accompanied by multiple pages of supporting documentation, such as lab reports and operative notes. While current forms are printed with red ink, Highmark's providers also submit claims on older Blue Cross/Blue Shield forms printed in blue ink, or photocopies printed in black ink. All forms and accompanying documents are 8.5" x 11".