Healthcare Payer IT
HIPAA Act of 1996 enforced healthcare covered entities to exchange administrative data in a unified X12 standard, but HIPAA didn’t focus on meaningful information content, data exchange architecture and data exchange security. As part of the Affordable Care Act (ACA), CORE, a committee under Council for Affordable Quality Healthcare, Inc (CAQH), developed rules so covered entities will adopt those standards and reduce the increasing cost of US Healthcare incurred by irregularities caused by data exchange. ACA also added other mandates such as IRS AIR Program, CMS EDGE Server and many others.
Client Challenges:
Health plans operate business with multiple systems and backend applications, with data scattered in various backend systems. The problem is not the delivery of the data, but more on the cost of delivery and ongoing maintenance.
Solution:
Our company specializes in providing IT consulting services that provides a “big picture” design structure capable of achieving data and record integration with disparate data sources, allowing big data collaboration with local, regional, and national organizations. The depth and breadth of experience and implementation expertise we bring to the table is exceptional.
Result:
We have already successfully completed projects for several Health Plans, smoothly transitioning our customers away from outdated, legacy technologies to mobile, cloud-based solutions
