Modern claims platform cuts talk time by 18%

Drawing on our decade-long relationship with their network and extensive experience modernizing dental platforms, we brought a strategic approach to the transformation. The client partnered with West Monroe to modernize its claims platform, targeting $5 million in financial benefits by selecting a solution that met both near-term and long-term goals. Our team conducted thorough analysis to identify the ideal platform solution, focusing on unique business requirements and measurable value creation. This objective approach led to selecting a network-developed claims platform that aligned perfectly with their needs, setting the foundation for both immediate improvements and long-term digital capabilities.

We assembled experts in dental operations, cybersecurity, change management, and program management to drive the transformation. Over a 24-month engagement, our team delivered a complete platform overhaul—balancing technology advancement with operational continuity. Together, we executed a precise four-phase implementation plan that included system development, process reengineering, and comprehensive change management. This collaborative approach ensured rapid adoption, with the platform achieving an 80% adjudication rate within two weeks of launch and processing more than 4,000 provider claims in the first month.

The transformation revolutionized operations across the organization. The new platform delivered immediate results—including 18% less talk time, 10% fewer manual claims, and 92% next-day payments—driving both efficiency and experience improvements. Enhanced analytics and visualization capabilities now enable better, faster decision-making. Digital channels provide improved sales and access capabilities for brokers and employer groups. The platform's ability to process new markets creates growth opportunities, while operational efficiencies drive significant cost savings. Most importantly, the modernization has transformed experiences for all stakeholders, from employees to providers to members.