Case Study
Payment Integrity Coding Services
Midwest Blue Payer | From T&M Staffing to Managed Business Process Outsourcing (BPO)
Challenge
A Midwest Blue payer initially engaged Walker for payment integrity coding through a time-and-materials model. As the need evolved, the client sought greater operational ownership, stronger performance visibility, consistent training, and a more structured governance model rather than traditional staff augmentation alone.
Solution
Walker transitioned the engagement to a managed BPO model, building and training a dedicated coding team and taking responsibility for onboarding, training materials, performance management, and day-to-day delivery. We established weekly governance meetings and structured reporting to track productivity, quality, individual coder performance, coaching needs, and operational issues.
Results
- T&Msuccessfully transitioned to BPO
- Dedicatedteam built and trained
- Weeklygovernance & reporting
- Structuredcoaching & issue resolution
Client Impact
Walker successfully operated the coding function as a BPO service, giving the payer greater structure, transparency, and accountability while maintaining strong client satisfaction. The engagement continued until the payer automated the underlying claims process, eliminating the need for manual coding and allowing the BPO service to conclude successfully as the client moved to a more efficient future-state model.