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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.

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