Case Study: Midwestern US State Department of Social Services achieves real-time Medicaid claims processing with Wipro

Wipro helped a Midwestern US State Department of Social Services move to a 99.75% paperless environment for Medicaid claims submission by automating its IT processes

The Midwestern US State Department of Social Services faced challenges with its outdated Medicaid Management Information System (MMIS), which created a slow, paper-heavy process. Its legacy architecture could not scale, leading to lengthy claims processing times and an ineffective self-service portal. To modernize and achieve a paperless, automated system, the department partnered with Wipro.

Wipro implemented a service-oriented architecture and a Commercial Off-The-Shelf (COTS) system to replace the client's entire legacy IT backbone. This solution automated claims processing and upgraded related applications. As a result, Wipro helped the client achieve 99.75% paperless claims submission, reduce average processing time from 2 days to 0.69 days, and realize annual savings of $2.9 million, all while enabling 100% real-time claim adjudication.