Overview
The client is a Billing Intermediary (between payer and provider), negotiating reasonable reimbursement rates and providing patient-friendly services such as Healthcare Concierge and Extended Coverage for out-of-network costs.
Genzeon is their dedicated IT partner and provides day-to-day support while aligning technology strategy with their business goals. We provide a full cycle of application design, integration, and management services. Working within a limited budget, Genzeon has helped the client achieve automation in their processes and low latency turnarounds for pay-outs.
Industry
Healthcare
Challenges
- To enable automated operation of provider network claims processing.
- To enhance data analytics and future growth within the current budget.
Solutions
- Complete Security Audit and Remediation.
- Automated System Monitoring and Alerting.
- Migration to Azure for an integrated user experience.
- Implementation of power BI for deeper analytics and insights.
- New platform to receive, parse, reprice, and transmit EDI X12 Claims.
Benefits
- Deeper data insights.
- More Efficient claims processing.
- Increased size of provider network.
- Enhanced revenue generation.
- Cost savings through Platform-as-a Service (PaaS).
- Better performance, reliability, and security.
