Case Study: a large regional health plan achieves $4M+ annual subrogation savings with EXL Health

Moving to full outsourcing subrogation services delivers over $4M annual savings

EXL worked with a large regional health plan that was using a co-sourced subrogation model, first sending cases without claims data and later providing claims but not case identification. After ten years in this arrangement, the customer wanted to improve recovery opportunities while reducing workload and other party liability (OPL) FTEs.

EXL implemented a full outsourcing model for subrogation services with a five-step end-to-end process covering identification, investigation, case management, recovery, credit, and reporting. EXL also created a hybrid global delivery model to meet regulatory requirements, reducing the customer’s FTEs by 50% and eliminating the need for non-OPL support resources. Recoveries increased by 50%, from $2.8 million to $4.3 million annually, with average savings of $4,178,601 per year from 2018 to 2021.