The client is a leading post-acute remote patient care management services company.
The company is dedicated to supporting the payers and providers in implementing strategies that ensure high-quality home-based care for patients.
The client minimizes placement times with their healthcare solutions and helps reduce the total cost of care.
They ensure the effective placement of referrals with top-quality providers for better outcomes and high member satisfaction.
Facing some critical limitations and performance issues related to the server capacity, stability, downtimes, and outdated UI, the client was looking forward to modernizing its legacy platform and migrating to a more sophisticated cloud-based platform.
The client wanted to transition from the referral-centric workflow to the more effective patient-centric workflow by implementing a Patient Medical Record Module.
Further, the company needed to promote seamless data exchange with external applications such as provider portals and referral systems.
The client was looking forward to integrations with third-party applications to streamline checks for eligibility criteria, service provider data, national provider data, and letters.
The client asked us to automate its utilization management workflows to reduce overhead and minimize manual interventions.
The client aimed to implement an end-to-end comprehensive letter generation and distribution management system.
To solve the client’s problems, our UI/UX team developed and implemented a user-friendly new gen interface with an intuitive design.
Next, we improved the patient medical record navigation and the intake and insurance eligibility check process by enhancing the workflow design.
We automated critical business rules and processes by implementing InRule as the key decision engine.
We built several useful integrations to streamline insurance eligibility verification with Axiom, claims processing with Plexis, letter generation with Forge and Evolve, and syncing of national provider data with NPPES.
Our solutions delivered tangible benefits that translated into measurable impact:
Modernizing the application also led to improved user experience with increased stability resulting in zero downtime.
