Health Insurer Expedites Claims Process; Ensures Compliance

Pam Roman

Insurance Company Stakes Its Claim for Modernization, Integration and Automation   Our client is the publicly traded holding company (HC) of seven insurance companies. They offer Medicare supplements; annuities; and life, long-term care, accident and health insurance to working-class families and senior citizens.   Challenge Older System Can’t Keep Up with Today’s Healthcare Demands HC’s claims-processing system was a homegrown, legacy environment — cobbled together using older technology that wasn’t … Read More

What’s Integration Without Visibility?

Pam Roman

Interoperability – the frictionless, secure exchange of electronic health data – is an ongoing goal for all healthcare organizations, whether payer, provider or otherwise healthcare related. If we define interoperability as being among different organizations, then it all has to start with integration within any one organization. You can’t effectively share with others if your own internal systems are siloed … Read More

Health Insurance Company Expected to Save $1M with New EDI Solution

Pam Roman

OUR CLIENT Our client is a health insurance company (HIC) that has operated in New York State for more than 80 years, evolving with our nation’s healthcare system along the way. CHALLENGE HIC was experiencing issues and limitations with its current electronic data interchange (EDI) set-up – the computer-to-computer exchange of insurance documents in a standard electronic format. First and … Read More

Short-Term Modernization Creates Long-Term Possibilities for Health Coalition

Pam Roman

Prolifics helps Health Coalition with Short-Term Modernization and Long-Term Possibilities Our client, a Health Coalition, is a non-profit organization that connects, collects and integrates health information in an exchange in partnership with its state’s department of health. Participating healthcare professionals (with patient consent) can access electronic health information and securely exchange data with other state participants. This improves patient outcomes, … Read More