Case Study: a large health insurance client reduces appeals and grievances with EXL

Large Health Insurance Client cuts AHT 49% with EXL

A large health insurance client needed to rapidly scale its utilization management appeals and grievances intake process to handle forecasted Medicare volume increases and avoid compliance risks. They partnered with EXL for expert offshore resources to improve efficiency and reduce administrative errors.

EXL provided and trained a team of resources, establishing real-time monitoring and support. This solution helped the client maintain implementation timelines and significantly improve operations. The measurable impacts included reducing average handle time from 902 to 456 seconds, achieving a 98.91% QA score, and maintaining zero attrition, all while effectively contesting previously denied appeals.