Case Study: Major Health Insuring Company achieves 45% cost savings and 99.5% claims accuracy with Hexaware

End to End Claims Management for a leading insurer and benefits administrator in US

Major Health Insuring Company, a leading U.S. health insurer and benefits administrator, faced an inefficient, largely manual claims operation that struggled with volume spikes, non‑formatted claims, accuracy issues and high costs. They engaged Hexaware to refit and streamline the end‑to‑end claims cycle using a People‑Process‑Technology approach and Hexaware’s hNext platform to digitize mailroom, capture and adjudication workflows.

Hexaware implemented a phased transition covering mailroom/scanning/indexing, digital capture, pre‑adjudication and adjudication with hNext tracking and EDI 837 uploads, plus verification and quality checks. The engagement delivered ~45% cost savings, accuracy of 99.5% (vs 95% expected), 5% year‑over‑year productivity improvement, reduced transition timelines by 2–4 weeks, and long‑term scale—11 years of partnership handling 6M+ claims/year and $1.8B in payouts across 9 locations.