Case Study: a major U.S. healthcare payer achieves significant payment integrity savings with EXL Health

a major U.S. healthcare payer boosts savings 45% year-over-year with EXL

A major U.S. healthcare payer sought improved results from its payment integrity program, specifically its data mining practice for identifying incorrect claim payments. Partner EXL offered a new approach by combining domain expertise, data and analytics, and its proprietary AI-driven models, including EXLMINE™.

EXL implemented a digitally-enabled data mining approach, utilizing a cross-functional hybrid team and robust analytics to identify claims with likely errors. This new method resulted in tremendous growth in savings, with EXL achieving a consistent 45% year-over-year growth in identified savings since 2020, a significant increase from the previous $25 to $30 million per year.