High-Stakes QBC System Overhaul Brings Cost-Saving Efficiency Improvements

“This was an ambitious claims system upgrade that required both automation expertise and insurance claims management innovation, ClaimVantage was the right choice.”

                          —Marc Lamirande, VP Technology, Quebec Blue Cross

 The Overview

Because Blue Cross is Canadian-owned and provides coverage to millions (1 in 4 Canadians have a Blue Cross plan), overhauling its claims management system was high-stakes project. After an extensive market evaluation, Québec Blue Cross (QBC) selected ClaimVantage.

The Business Problem

QBC had a legacy claims system with productivity inefficiencies and redundancies, as well as time-consuming manual
work-around steps that lacked controls.

Specific Goals:

  • Streamline adjudication, medical management, and payments
  • Enhance overall claims servicing
  • Facilitate return to work more effectively
  • Integrate with existing Policy Administration and Financial systems
  • Leverage rules-based workflows for pre-eligibility, eligibility and payment calculations
  • Improve worker productivity and prioritization

The Solution

ClaimVantage had unique expertise and innovative capabilities that enabled QBC to install the most comprehensive and cost-effective claims management platform, for both disability and life insurance claims processing. Using an incremental 10-month implementation strategy, QBC deployed ClaimVantage to streamline their claim management process, automate their eligibility process, and even integrate policy, financial, and check printing systems. The ClaimVantage solution extensively improves worker productivity resulting in more than 200 claims and 300 payments per day, using fewer  resources.