Imagenet: Helping Healthcare Payers Beat the 'Great Resignation'

Patrick Smith, Chief Operations Officer
The need to digitize the end-to-end claim processing mechanism has been growing over the past decade but became increasingly more important during the pandemic due to the majority of the workforce working from home and the lack of force in the healthcare sector. During this time, health plans were under the same level of scrutiny to process claims in a timely manner while dealing with health and safety concerns in concert with ‘great resignation’. Fortunately for some of the payer organizations, Imagenet’s team’s expertise came in handy as the company was able to augment the workforce, provide digital and staffing solutions, and adapt to a newer reality.

“We’ve accomplished that through a couple of different means: we added our digital operations in the form of mailroom support, paper to EDI claims conversion, claims adjudication, as well as our contact center services,” says Patrick Smith, Chief Operations Officer, Imagenet. “These services operate 24 by 7, 365 days a year, providing our clients unparalleled access to technology processes and skilled resources.” The company provides digital transformation and BPO services to more than 250 payers across the U.S for their claims operations, mail rooms, workflow solutions and contact center services.

The clients call for help from Imagenet for a particular health plan, where Imagenet receives paper claims forms and medical records like X-rays, digitizes those documents, and returns electronic files to the clients. The clients can then automate the downstream processes, improve data analytics and develop a document repository that’s HIPAA compliant. In addition, the company provides claims adjudication services, where they will augment the workforce of a health plan using skilled adjudication resources. Imagenet trains the workforce on how to review the claims, properly pay them and provide appropriate denial or rejection reasons using their in-house proprietary technology. The company also provides reporting and analytics on financial and procedural accuracy to its clients. Finally, from a customer support perspective, Imagenet furnishes solutions using a cloud-based elastic call center, which can be easily scaled leveraging resources across the U.S.
The company offers a digital workflow solution, Jetstream, that can take documents and data, route those around organizations to different teams and departments, and give them the capability to make better and quicker decisions. Within Jetstream, the clients can design their custom workflows and analytic solutions to analyze the data they’re working with and make sure that the software matches their process versus their process. Imagenet incorporates industry best practices to keep the client’s business running compliant and smoothly.

We’ve accomplished that through a couple of different means: we added our digital operations in the form of mailroom support, paper to EDI claims conversion, claims adjudication, as well as our contact center services

The company received the opportunity to work with a large healthcare payer that operates out of all 50 states within the U.S. Before Imagenet, they had low productivity and throughput on their claims processing or claims adjudication business and had a high abandonment rate on the calls. Imagenet came in and put together a project portfolio that addresses all of their operational team points, improves the quality and performance of their adjudication department through Imagenet resources and services, and improves their customer satisfaction and call handle rates.

Imagenet has been growing steadily and targets significant expansion of its contact center and claims adjudication services. Targeting a 30 to 40 percent growth in each of the company’s divisions, Imagenet wishes to cater to the demand of the healthcare industry and service those clients.


Tampa, FL

Patrick Smith, Chief Operations Officer

Provides digital mailroom and virtual reject letter services, claims adjudication, contact center services, and digital workflow platforms.