One of largest US Healthcare Providers improves budgeting and forecasting accuracy and addresses complex compliance mandates.
Challenges
The Healthcare provider needed a denials management solution to meet changing compliance mandates related to HIPAA and CMS and regulatory updates for Medicare and Tricare. Additionally, they wanted to standardize communication between providers and payers.
Solutions
Persistent delivered an integrated revenue and denial management solution that automates several business processes to improve revenue recognition and reduce reimbursement denials.
- Meets compliance requirements for HIPAA, CMS, ANSI 837 AND 835 forms
- Increased agility thru a microservices architecture that replaced a monolithic application
- Introduces business process automation to streamline processes
- Enterprise-based print management service automates entire process to reduce printing costs and manual efforts
Outcomes
The solution delivered streamlined business processes for denial management including contract modelling process with Agile methodology that dramatically reduced manual hours and customer release cycle by 50%.
Technologies Used
- Microsoft Azure
- RedHat Openshift
- Oracle Exatada
- K2
