Operations Transformation

Strategic Initiatives for Operational Excellence

Intelligent automation and unified platforms across Claims, UM, and Member Services

Strategic Roadmap

Executive Summary

Prioritized topics driving operational excellence and digital transformation

Focus AreasStatus
Claims - Digital Sorting

Scan mail at receiving location as first step, perform automated machine sorting on digital copies for 90%+ claims, provide advanced UI for exception scenarios where human interventions are required

In Focus
Claims - Indexing

Introduce capture tool with 95% field accuracy (not requiring intervention), remaining 5% handled in advanced UI, replace ImageNet third-party vendor with in-house tooling and offshore indexer staff

In Focus
Auth & Corro - Digital Sorting

Leverage tooling introduced in Claims Sorting (conceptually similar). Replace Macess DocTriage with advanced digital sorting module capable of detecting document boundaries and auto-classifying/routing faxed, mailed, or other source incoming documents

In Focus
Auth & Corro - Indexing

IBML Initiative is already ongoing addressing this automation opportunity. Double-confirm extracted data and perform system lookups (member, provider, auth, eligibility) to ensure documents are properly contextualized before routing

Underway
Voice-Bots

Identify best candidates in terms of call frequency, complexity, and time consumption per communication type, then introduce bot replacements for high-volume routine interactions

In Focus
IDM Enhancement / Replacement

Phased migration to modern correspondence management with template modernization

In Focus
360 Member View

Replace Macess Docviewer with advanced Review tool. Improvement and evolution of in-house tools like Fixer with enhanced capabilities: unified data aggregation layer, in-app pricing calculator, full-text document search, collaborative annotations. Collaborative effort with in-house team to build unified front-end layer

In Review
Claims - Autoadjudication

Execute ML algorithms to find common/correlated properties for claims that are sent to manual adjudication but always approved, then expand auto-adjudication rules based on findings

In Review
Macess File Cabinet Evaluation

Comprehensive capability assessment and gap analysis to understand which Macess features are actively used versus available product capabilities. Evaluate technical debt, integration points, and develop technology roadmap for modernization or replacement options

In Review
Smart Work Distribution

Build intelligent routing engine with granular skill set mapping and workload balancing

In Review
Misdirected Claims

Redesign communication workflows and notification processes for misdirected claims

Underway
Claims Processing

Claims - Digital Sorting

Transform physical mailroom operations by replacing manual human sorting with intelligent digital classification. Scan mail in-house on day-zero and automate 90%+ of sorting work.

Process Transformation

Inefficient

Current Process

Manual, paper-based workflow

1

Mail Arrival

Physical mail arrives at mailroom

2

Manual Sorting

Staff manually sort every page by type, member, claim

3

Insert Separators

Physical separator sheets with control numbers added

4

Courier Pickup

Physical transport to Imagenet vendor

5

Vendor Scanning

Imagenet scans, indexes, and keys data

6

Data Delivery

TIFFs to EDI team, data file to EZ-Cap

Total Time: 2-3 days
High cost, high risk, low visibility
Optimized

Proposed Process

Digital-first, automated workflow

1

Mail Arrival

Physical mail arrives at mailroom

2

Instant Scanning

High-speed scanner captures all pages in sequence

3

Digital Sorting

Software auto-detects boundaries, 90%+ accuracy

4

Human Review

Staff validate digital sorting on screen

5

Immediate Transmission

Digital files sent to Imagenet continuously

6

Data Processing

Imagenet performs data keying only

Total Time: Same day
Lower cost, lower risk, full visibility
2-3 daysSame day70% faster

Interactive Process Canvas

2-3 Days ProcessingSame Day Processing
Hover over any step to see details

Key Benefits

Reduced Time Spent on Sorting

Staff no longer spend hours manually sorting paper. They simply scan and validate digital suggestions on screen.

Faster Delivery to Imagenet

Documents are scanned in-house and transmitted immediately. No more waiting for daily courier pickup. Continuous delivery throughout the day.

Normal Working Hours

No more early morning wakeups required. Mailroom shift can start at regular business hours since digital processing eliminates courier pickup deadlines.

Foundation for Non-Claims Intake

Sets up the foundation and tooling to improve intake processes for all Non-Claims channels including faxes, digital submissions, and provider uploads.

No Courier Cost

Eliminates direct courier expense and indirect costs of scheduling, coordination, and handling delays. Digital handoff is instantaneous.

No Cost for Separator Sheets

No printing or inserting physical separator sheets. Staff no longer maintain inventory or manage control numbers manually.

Lower Vendor Costs at Imagenet

Imagenet performs only data keying—no sorting, scanning, or batch prep. 60% cost reduction expected.

Better Staffing Flexibility

Digital work can be shifted to other teams or locations. Remote staff can participate in classification. Dynamic reallocation during surges.

Immediate Visibility Into Mail Volumes

Real-time dashboards show mail arrival, document types in queue, and bottlenecks. Eliminates black box period between arrival and processing.

Earlier Start on Downstream Work

Claims, UM, appeals, and provider ops receive documents hours earlier. Improves SLAs and reduces aging backlogs.

Reduced Risk of Lost or Misrouted Mail

Digitizing immediately removes physical handoff risks. Every page is captured, tracked, and audit-ready from day one.

Stronger HIPAA & Security Controls

Mail no longer transported offsite. Access governed through system permissions, audit trails, and automated logging.

Enhanced Disaster Resilience

Digital copies eliminate catastrophic risk of losing irreplaceable physical mail to fire, flood, or other disasters.

Future Automation Pathway

Digital foundation enables future document recognition, ML-based splitting, auto extraction, and auto matching to members and providers.

Phased Execution Roadmap

Step-by-step rollout approach. Start with foundation setup, then deploy iteratively PO Box by PO Box. No big-bang deployment - each step is validated before moving to the next.

Foundation Setup

Setting up integration and scanning routine

Configure watched folders for scan output
Simple scanning with envelope separators only
Set up output locations and file routing
Test outbound delivery and validation
Establish connection to downstream systems
Test file transfer and validation pipeline

Pilot PO Box

First PO Box rollout with highest volume

Deploy to selected PO Box
Parallel run with existing process
Validate accuracy and throughput
Gather feedback and refine workflow

Iterative Rollout

Expand PO Box by PO Box

Roll out to next PO Box after validation
Repeat for each remaining PO Box
Continuous improvement between rollouts
Full deployment across all 7 PO Boxes
Claims Processing

Claims - Indexing

Software tooling for automated claims indexing with human-in-the-loop review. State-of-the-art extraction combined with fast correction UI enables Conifer to outsource or offshore indexing at lower cost with faster processing rates. Integrated lookups validate data early, reducing downstream errors.

The Approach

Current State: ImageNet

  • Third-party vendor handles claims indexing
  • Limited visibility into process and quality
  • Fixed pricing model with vendor dependency
  • Evaluate current ImageNet capabilities and costs

Proposed: In-House Software Tooling

  • Automated extraction with confidence scoring
  • Human-in-the-loop UI for fast review and corrections
  • 95% field-level accuracy on average - minimal corrections needed
  • Flexible outsourcing or offshoring options
  • Full control over quality and costs

How It Works

1. Document Arrives

Digitally sorted claim enters queue

2. Auto-Extraction

System extracts all fields

3. Integrated Lookups

Member, provider, auth, dup checks

4. Field Validation

95% fields correct on avg

5. Human Review

Fast correction UI (if needed)

6. EZ-Cap Ready

Data populates claim record

Early Error Detection with Integrated Lookups

Data validation happens early in the indexing process, catching errors before they propagate. Unlike the current ImageNet setup where Conifer must fix vendor errors downstream, issues are addressed at the source—reducing complexity, rework, and downstream processing delays.

Member Eligibility
Provider Validation
Authorization Check
Duplicate / Corrected Claims
95%

Field-level accuracy (avg)

~5%

Fields needing correction

Extraction Fields Overview

Member Info

  • Member ID
  • Name
  • DOB
  • Group Number

Provider Info

  • Provider NPI
  • Facility Name
  • Tax ID
  • Address

Claim Details

  • DOS
  • Billed Amount
  • Procedure Codes
  • Diagnosis Codes

Document Meta

  • Document Type
  • Page Count
  • Received Date
  • Source Channel

Key Benefits

State-of-the-Art Extraction Engine

Modern extraction technology identifies and captures key data fields with high accuracy, reducing manual indexing effort.

Human-in-the-Loop Review UI

Intuitive correction interface allows reviewers to quickly validate and fix extraction results. Only claims needing human touch are surfaced.

Integrated Lookups During Indexing

Member, provider, authorization, and duplicate/corrected claims lookups happen early in the process. Issues are caught and returned to indexers for immediate correction instead of Conifer fixing vendor errors later.

Faster Indexing Rates

Automated pre-extraction combined with streamlined review reduces per-claim indexing time significantly.

Lower Indexing Costs

Software tooling enables Conifer to outsource or offshore claims indexing at reduced cost while maintaining quality.

Outsourcing & Offshoring Ready

Web-based tooling can be deployed anywhere, enabling flexible workforce options and cost optimization strategies.

Quality Control Built-In

Confidence scoring, exception routing, and audit trails ensure accuracy regardless of where indexing is performed.

Expected Outcomes

40%

Cost Reduction

Via outsourcing/offshoring

95%

Extraction Accuracy

For all fields on average

~5%

Less than 5% Fields Need Intervention

Minimal human touch

Phased Execution Roadmap

Deploy extraction tooling, validate with pilot batches, then scale to enable outsourcing and offshoring.

1

Tooling Setup

Deploy extraction engine
Configure field mappings
Set up review UI environment
Establish confidence thresholds
2

Pilot & Validation

Process sample claim batches
Train reviewers on correction UI
Measure accuracy and throughput
Refine extraction rules
3

Scale & Optimize

Enable outsource/offshore teams
Expand to full claim volume
Continuous model improvement
Cost tracking and optimization
Claims Processing

Claims - Autoadjudication Improvement

Leverage data extracts from EZ-Cap to detect patterns in non-autoadjudicated claims. Identify claims that are consistently untouched during processing and safe to add to the auto-pass set, increasing straight-through processing without compromising accuracy.

The Opportunity

Current State

  • Conifer has improved autoadjudication rates through constant evolution and scripting
  • Current approach relies on examiner experience and report analysis
  • Manual scripting has natural limits in discovering hidden patterns
  • Opportunity to go further with data-driven pattern discovery

Proposed Approach

  • Find correlations based on evidential facts in EZ-Cap data
  • Different approach: let data reveal patterns, not manual scripting
  • Shadow test before enabling new autoadjudication rules
  • Gradually expand auto-pass set with continuous monitoring

How It Works

1. Data Extract

Pull claims history from EZ-Cap

2. Identify Patterns

Find untouched claim characteristics

3. Shadow Test

Validate predictions on live claims

4. Expand Rules

Enable new auto-pass criteria

5. Monitor

Continuous accuracy tracking

Claims Characteristics

  • Claim type & subtype
  • Provider specialty
  • Service codes
  • Diagnosis combinations

Processing Outcomes

  • Touch count (zero/one)
  • Adjustment patterns
  • Denial rates
  • Processing duration

Historical Behavior

  • Provider payment history
  • Member claim patterns
  • Contract terms alignment
  • Pricing consistency

Data Quality Indicators

  • Field completeness
  • Code validity
  • Eligibility match rate
  • Authorization presence

Key Benefits

Increased Straight-Through Processing

Expand auto-pass claim set by identifying claims that consistently process without manual intervention.

Reduced Manual Touch

Focus examiner effort on complex claims that truly need human judgment, not routine claims stuck in queues.

Data-Driven Decision Making

Pattern analysis provides evidence-based criteria for expanding autoadjudication rules, not guesswork.

Risk-Controlled Expansion

Gradual rollout with continuous monitoring ensures accuracy is maintained while throughput increases.

Measurable Impact

Clear metrics on claims migrated, touch reduction, and processing time improvement track ROI.

Transparency & Auditability

Every auto-pass decision is logged with the pattern criteria that qualified it for expanded processing.

Phased Execution Roadmap

Extract data, analyze patterns, validate in shadow mode, then gradually expand autoadjudication rules with continuous monitoring.

1

Data Extraction & Analysis

Extract historical claims data from EZ-Cap
Identify claims with zero/minimal touch
Analyze common characteristics
Build initial pattern library
2

Pattern Validation

Shadow mode testing on live claims
Compare predicted vs actual outcomes
Refine pattern criteria
Establish confidence thresholds
3

Controlled Expansion

Gradually enable new auto-pass rules
Monitor accuracy and exception rates
Continuous pattern refinement
Scale to additional claim types
Non-Claims Processing

Non-Claims - Digital Sorting

Unify intake for authorizations, correspondence, and medical records across all channels—fax, mail, email, and portal uploads. Replace Macess DocTriage with a single intelligent platform.

Unified Intake Channels

Fax Lines

Inbound faxes from providers and plans

Physical Mail

Non-claims correspondence and documents

Email

Digital submissions and attachments

Provider Portal

Uploaded authorizations and records

Document Types & Routing

Authorization Requests

UMCase Management
High

Medical Records

UMAppeals
High

Provider Correspondence

Provider Ops
Medium

Member Communications

Member Services
Medium

Appeal Submissions

AppealsUM
Medium

Clinical Documentation

Case ManagementUM
High

Key Benefits

Unified Intake Pipeline

All non-claims documents flow through one platform regardless of source—fax, mail, email, or portal upload.

90% Automated Routing

Intelligent classification routes documents directly to IBML without manual intervention for most cases.

Replaces Macess DocTriage

Consolidates functionality into the unified platform, eliminating redundant systems and licensing costs.

Reduced Manual Effort

Staff focus on exception handling rather than routine classification and routing tasks.

Faster Processing

Documents reach UM, Case Management, and Provider teams same-day instead of next-day.

Consistent Handling

All channels processed with identical rules, ensuring uniform quality and audit compliance.

Phased Execution Roadmap

Incremental rollout by fax line, mail channel, and document type. Parallel running with DocTriage during validation.

1

Foundation

Weeks 1-4

1 Primary Fax Line
Face Sheets (selected doc type)
Validate fax ingestion
Train classification
Measure pass-through rate
2

Expansion

Weeks 5-8

+ Mail + 2nd Fax Line
+ Medical Records
Multi-channel validation
Improve accuracy
Add routing rules
3

Scale

Weeks 9-12

All Fax + Mail + Email
+ Appeals, Correspondence
Full deployment
Retire DocTriage
Unified reporting
In Focus

Unified 360° Member View

A single, unified review and inquiry interface providing a complete view of each member across Claims, UM, Case Management, and Provider Engagement teams

The Challenge Today

Team members must open and cross-reference several systems—EZ-Cap, Macess, CAP Connect, benefit guidelines, CMS pricing tools, pharmacy calculators, immunization portals, and provider directories—just to assemble basic context around a claim or authorization. This fragmentation slows down processing, creates inconsistent results, and forces teams to repeat the same work.

Unified Layer Architecture

Front-end layer retrieving information from multiple systems into one structured view

360° Member View

Unified Front-End Layer (Read-Only Initially)

Smart Search Ask Document Image ↔ Data Link Auto Calculations
Aggregates Data From
EZ-CapClaims & Auth Data
MacessImages & Correspondence
CAP ConnectProvider Network
CMS PricerPricing Tools
Pharmacy CalcDosage/Units
Immunization PortalVaccination Records
Benefit GuidelinesUM Policies
Provider DirectoryFacility Lookup

Key Capabilities

Multi-System Aggregation

Single workspace displaying claims, auth data, images, benefit rules, pricing, pharmacy calculations, and provider lookups

  • Claims and auth data from EZ-Cap
  • Images and correspondence from Macess
  • CMS pricer data (no manual website navigation)
  • Pharmacy dosage/unit calculations
  • Immunization history
  • Document-based duplicate/overlap detection

Modern Image ↔ Data Review

Link system fields directly to highlighted areas on scanned documents

  • Field-to-document highlighting
  • Grouped related fields
  • Visual cues for faster checking
  • Text search on images
  • Predefined quick searches (EOBs, UB04, medical records)

Natural-Language Inquiry ("Ask the Document")

Staff can ask questions directly against document content

  • "Where is the discharge date?"
  • "Show me all diagnoses mentioned"
  • "Highlight medications"
  • Results highlighted in document viewer
  • Especially helpful for non-standard documents

Team-Specific Modules

Shared interface with specialized capabilities for each team

Claims & Pharmacy
  • Automated unit and dosage calculator
  • Allowed vs billed amount comparison
  • Key financial field highlighting
Utilization Management
  • Direct policy/guidelines access
  • Eligibility checks
  • Historical auth connections
Case Management
  • Consolidated patient history
  • Immunization data integration
  • Standardized care goals/letters
Provider Operations
  • Provider lookup
  • Facility contact information
  • Network/contract status

Incremental Delivery Approach

This tool can be delivered in small, manageable steps, where additional features in the viewer are added one by one—allowing the organization to introduce value quickly, validate each improvement, and expand capabilities gradually without a large disruptive overhaul. Initially read-only, with optional expansion later (notes, tasks, or selected field edits to EZ-Cap).