While a great deal of process improvement work has finally begun to take hold within healthcare around patient safety and hospital operational efficiencies, what about the other non-clinical aspects of the overall healthcare system which can consume physician resources and adversely impact hospital finances? Healthcare insurance processes can have a major impact on both patient care as well as operational efficiencies. This paper describes how one healthcare insurance company has begun to use Six Sigma to not only make itself more efficient and effective internally, but is now also directing its energies toward lowering medical costs while improving patient service and outcomes