Custom Application Development by Upp
Gives Noridian Competitive Edge in Claims Processing

Client Profile:

Noridian Administrative Services is a large Medicare claims contractor providing processing services for 12 midwestern and western states. Allied and subsidiary companies include: Noridian Administrative Services, LLC; Lincoln Mutual Life & Casualty Insurance Company; Noridian Insurance Services, Inc.; and Claims and Benefits, Inc. With a large footprint in the Insurance and Claims Service industries, Noridian's ability to provide customers with claims processing at competitive costs became a necessity.

Solution:

Upp IT consultants assisted in the implementation of Noridian's “Extended Claims Processing Initiative,” an aggressive plan to increase processing capabilities, while supporting expansion to new state markets. The efforts necessary to begin processing member claims for a new state required comprehensive planning. Four unique teams were required for the necessary conversion, testing, and auditing to occur. Upp consultants provided initial data conversion support to the Provider Team, which handled physician and facility registrations.

The Membership Team utilized Upp consultants' knowledge to assist in the conversion of end-subscriber membership data and to plan processing workflows in the Noridian Unisys environment. The remaining two teams, Institutional and Professional, managed claims processing for both Hospitals and Doctors. Upp consultants have assisted in modifying and managing thousands of unique plan workflows for high-volume claims groups.

Business Value:

As part of the Noridian team, Upp consultants are counted on to provide industry experience and modern IT skills, helping achieve lower costs and superior service to a large portion of the nation's Medicare-covered population. Noridian's claims expertice, coupled with Upp's IT modernization teams, have helped the company not only to stay ahead of the business curve, but also to exceed the service expected from today's insured professionals and institutions.