Claims Processing and Plan Services

Business process outsourcing and ASP services provide strategic advantage for health plans and administrators

Outsourcing services deliver benefits that help health plans succeed in the marketplace. These benefits include the ability to reduce transaction costs, improve service levels, speed membership growth without adding infrastructure and focus on core competencies and lines of business.

Many health plans have determined that outsourcing all or a portion of the administrative workload is the most economical or best strategic approach. Other plans want to keep administrative functions in-house but don't want the responsibility of maintaining an expensive, complex network data center which can include ongoing hardware and software maintenance and updates, IT personnel costs, EDI and complex integration issues. To address these needs, DST Health Solutions offers business process outsourcing (BPO) and application service provider (ASP) services.

DST Health Solutions' Health Plan BPO customers outsource all of their information technology and some or all of their administrative functions to us. Through DST Health Solutions' administrative service centers, our customers utilize our personnel and technology to perform administrative services that include:

• Mailroom and claims document intake, imaging/OCR and data capture
• Claims adjudication, resolution and workflow support
• Customer, group and provider services
• Membership/enrollment processing
• Billing and collections
• Check/EOB processing

DST Health Solutions' specialty BPO services include Internet-enabled transaction-based processing, multi-shore services, new product launches and claim backlog management. DST Health Solutions' IT services include facilities management, system hosting and operations management, systems planning, tuning and maintenance, applications maintenance and support, enhancements and conversions and much more.

Outsourcing Quality Programs and Best Practices

DST Health Solutions' approach to quality is focused on process improvement. We apply our own proven methods, including Quality Before Design (QBD), a disciplined requirements gathering approach that ensures client expectations are met upon project delivery. Our proven project management methods allow us to complete projects without cost overruns, missed deadlines or unexpected delays. We engage in industry quality programs such as ISO 9001, SEI CMM, Six Sigma and SAS70 assurance to deliver accurate, consistent and measurable results.

For info on Claims Processing & Plan Services: inforequests@dsthealthsolutions.com.