About the Case
Cook Children’s Health Plan engaged Divurgent to navigate the complex operational changes associated with the implementation of Epic Tapestry, the industry-leading insurance operations support software, and Healthy Planet, Epic’s population health management module.
To meet the challenge, the Divurgent Advisory Team bridged the gap between technology and operations by leading and managing the overall operational project across compliance, network development, provider relations, and quality improvement workstreams.
Our Partner
Cook Children’s Health Plan is a local non profit health plan that offers affordable quality health care plans for the whole family. The organization has more than 570 doctors, over 1,3000 specialists, and 43 hospitals in their network.
Our Solution
- Discovery & Gap Analysis
- Operations Advisory
- State Readiness
- Operations Project Management
The Result
- Successful conversion and adoption of new systems with minimal issues at the time of go-live
- Claims Auto Adjudication Rate 24% above target and 41% above baseline
- Saved 41.8 hours by achieving CRM turnaround time of 6.2 hours, compared to their 2-day target
- Saved .5 days in Authorization Time, compared to their 3-day target
