Case Study: Care1st Health Plan Arizona achieves faster claims processing and automated entry of 43,000+ provider records with Nintex Foxtrot RPA

Care1st Health Plan Arizona - Customer Case Study

Care1st Health Plan Arizona, a Phoenix-based Medicaid payer, faced a sudden enrollment jump from roughly 50,000 to over 70,000 members after expanding into Pima County and becoming a TPA for the new Marketplace. That growth required fast, accurate updates to tens of thousands of provider records (panel sizes, eligibility, fee schedules, etc.), but their existing macros were unreliable and required constant monitoring, delaying claims payments and tying up staff.

Care1st replaced fragile macros with Nintex Foxtrot RPA “automated employees” to perform data entry and maintenance. The RPA automated roughly 43,000 provider records, cut a panel-update task from 8–10 hours to 1 hour, increased claims approvals from about 3 to 20 claims per minute, and added 1,100 NDC codes in one minute — delivering far faster, more accurate processing and freeing staff for higher-value work.

Care1st Health Plan Arizona

Ivy Boyer

Manager of Business Application Systems