January 1, 2005 (Richardson,TX) GTESS began tracking the operational metrics of its clients in its annual Benchmark Survey during the 2003 Partners Forum. Each year, the survey significantly expands in both client participation and benchmark statistics. The aggregate benefits administrator/HMO/indemnity data presented in the 2005 report represents 13.6 million covered lives and 27.3 million claims per year.
The Survey provides an analysis of clients' operational metrics such as claim auto-adjudication rates, turn-around time and cost. Additionally, participating in the Survey provides an opportunity for clients to work directly with their GTESS account executive and assess their client-specific data to identify best practices and areas for improvement. We plan to conduct this survey annually and offer our clients the ability not only to benchmark themselves against each other, but also over time.
2004 - 2005 Results Comparisons:
TPA client reporting shows a 34% decrease in the average processing cost per claim.
The average processing cost per claim decreased 56% for HMO/PPO clients who reported during both survey years.
About GTESS Corporation
GTESS Corporation provides customers with a total pre-adjudication medical claims processing solution called the Claims Gateway Solution — a single portalaccess to a suite of five integrated, client-customized software modules forEDI receipt, data conversion, claim cleaning, network management / repricing,claim edit resolution and document management.
The Claims Gateway Solution uses business process management (BPM) technologies to create new efficiencies and offer process transparency throughout the claim process. Our ‘clean-claim’ HIPAA-compliant electronic data interchange (EDI) delivery systems go beyond what can be achieved by automating parts of the process, or outsourcing operations off-shore. For more information please visit www.GTESS.com.