VGZ Cuts 30% of Costs for Claims Processing and Policy Administration Through Use of Health Insurance Technology
 
 

VGZ Cuts 30% of Costs for Claims Processing and Policy Administration Through Use of Health Insurance Technology

  • Oracle Customer:  VGZ
    Location:  Arnhem, Netherlands
    Industry:  Healthcare
    Employees:  2,800
    Annual Revenue:  Over $5 Billion

VGZ is a nonprofit health insurer, playing an active role in organizing smarter healthcare in the Netherlands. With more than 4.1 million policyholders and 187 million claims processed each year, it is the second-largest healthcare organization in the country. Its goals include providing affordable healthcare that is based on qualitative medical services, excellent customer service, and superior operational efficiency.

VGZ wanted to consolidate three of its management applications—acquired through the merger of three organizations—into a single health-insurance-specific platform to enable the company to respond rapidly to frequent and complex changes in Dutch healthcare insurance laws. In addition, it wanted to improve customer service by offering self-service functionality, and to cut IT costs for management and support, as well as gain an advantage in a highly competitive sector.

The company’s deployment of Oracle Health Insurance Back Office improved the company’s ability to support its customer service, internet sales, provider contracts, policy administration, claims processing, pre-authorizations, and billing functions. With the solution, VGZ reduced operational costs by 30%, thanks to straight-through processing of claims to achieve a yearly savings of US$10 million in IT expenses and US$24 million in operational costs for claims.

 
 

 
 

Challenges

A word from VGZ

  • “With Oracle Health Insurance Back Office, we have reduced operational costs related to claims processing and policy administration by 30%.” – Adriaan Baan, Head of Claims Department, VGZ

  • Consolidate three disparate applications into a single health-insurance-specific platform to respond rapidly to frequent, complex changes in Dutch healthcare insurance law
  • Gain efficiency in claims handling through claims digitization
  • Cut costs for both claims handling and processing and general IT support
  • Improve customer service for more than 4.1 million policyholders and 300,000 healthcare providers (including hospitals, doctors, dentists, and pharmacies) with extra support for the company’s Web channel and self-service functionality

Solutions

Oracle Product and Services

  • Consolidated three separate management applications into the Oracle Health Insurance Back Office platform, integrating and providing increased support for functions, such as customer service, internet sales, provider contracts, policy administration, claims processing, pre-authorizations, and billing
  • Lowered the number of full-time employees involved in claims handling from 640 in 2008, to 250 in 2012, thanks to straight-through claims processing and automated validations of cost declarations
  • Reduced operational costs by 30% by simplifying processes and making organizational changes, resulting in an annual IT savings of US$10 million and US$24 million for operational costs associated with claims
  • Improved customer satisfaction by implementing self-service functionality for healthcare providers, allowing direct delivery and the ability to check cost declarations, thus improving operational excellence, thanks to a 95% adoption rate for the use of digital invoicing between VGZ and healthcare providers
  • Improved call-center services and self-service for members and providers delivered through VGZ’s Web site, providing users with instant access and rights to change their personal contact and billing data, which resulted in reducing output by postal mail