Case Study: Screen Actors Guild – Producers Pension and Health Plan achieves streamlined, HIPAA-compliant electronic claims processing with OpenText Case360

Actors Health Provider Releases Sequel to Claims Processing

The Screen Actors Guild – Producers Pension and Health Plan (SAG-PPHP) manages benefits for 66,000 participants and dependents and processes more than 750,000 medical claims a year. Faced with a high volume of paper files, slow manual processing and the need to meet HIPAA requirements, the organization needed a way to convert documents to electronic form, speed adjudication and improve member service.

SAG-PPHP implemented OpenText Case360 integrated with OCR, its claims system and a HIPAA exchange server to transform 837 electronic claim transactions into formatted images viewable alongside supporting documents. The solution reduced process steps from 26 to 6, enabled workload balancing, faster document retrieval, more accurate claims handling and simplified HIPAA compliance.

Screen Actors Guild

Amanda Bernard

Executive Project Manager