Initial Business Transformation Project Reduces Errors and Streamlines Patient Care



Problem

Through acquisitions, this client in the healthcare space essentially had two competing claims management platforms due to two similar companies merging. This caused redundancies and cost inefficiencies. The client had been utilizing an offshore development provider that wasn’t delivering. They created a business case for one integrated front end and back end solution to handle all of their transactional business, and needed support in reaching this vision.


Solution

The focus of the initial engagement was to standardize and integrate data between the two platforms. Our team’s first step was to stabilize the functionality, reduce data errors and resulting claims processing, as well as creating a path toward a single long-term solution. Because the efforts leading up to that point were centered around data normalization, the client needed our team to focus on modernization, architecting, and systems integration.


Results

Once our team achieved standardization and data normalization, the client was able to more effectively manage their overall provider network, masking the reality of two separate platforms. The client, as well as the providers and patients all benefited from this solution. The new standard data model with good data allowed the client to efficiently and effectively manage their claims process and deliver patient care in a more streamlined manner. The future work from this initial project will allow the client to build a single user interface to connect all ancillary systems, and will result in more efficient patient and provider interactions.

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