Application Modernization & Unified Payer Services for a Leading Revenue Cycle Management Company.
Overview.
Our Client is a US-based leading provider of revenue cycle management services and solutions to healthcare providers. Its EHR-agnostic patient access and care coordination solutions support thousands of providers and sites of care across the US. Fragmentation across various systems and resources, compounded using on-premises servers, collectively led to delay in the patient journey for accessing payer services.
The organization faced integration issues due to multiple payer channels resulting from mergers and acquisitions, leading to inconsistent and costly payer connectivity.
Solution
Refactored monoliths to microservices to enable a new business model with greater automation and STP reducing the FTEs needed to deploy a solution.
API Enablement strategy to connect to hospital and healthcare providers.
Created a universal service that exchanges data with payers to enhance and innovate products and services.
FHIR implementation for enabling data exchange across different health systems.
The Impact
Modern architecture enabled seamless onboarding of new healthcare providers.
Saved over $25 million in FTE and technology costs over 3 years.
Increased FTE savings through enhanced automation.
Optimized payer connection costs and contract negotiations with new Payer Service migration.
Scaled transaction volumes exceeding 125 million using centralized technology.
Achieved significant cost savings in infrastructure and licenses with new technology architecture.
