Case Studies

About the Client

Our Client is one of the leading providers of healthcare solutions for anesthesiology and other specialties to physicians, hospitals and outpatient centers with revenues of US$ 1 to 2 Billion. Customer provides comprehensive hospital-based clinical and management solutions for anesthesia outsourcing and other specialty areas including emergency medicine, women's and children's and radiology.

Goals & Challenges

  • The manual process of Appeals and Refund resulted in delayed / missing deadlines. Customer had originally engaged another company to automate the processes, but the said company could not abide by their delivery promise. With a very limited budget and short timelines, Skywalk Global took over the task, completed the process automation and Integration with partners to the satisfaction of the Customer.

Solution

  • Re-Engineered the Payment Posting and Reimbursement modules.
  • Developed Appeals Management and Refund Process.
  • Implemented ICD 10 support, ANSI Management module were some important deliverables which formed the part of the Solution.
  • Skywalk Global resources from different verticals were pooled to design and implement this massive solution resulting in timely completion of the project and thereby improved productivity to our Client.

Results

  • Removal of the manual processing of Appeals management and Refund process.
  • Reduction in the time taken to file Notice of Appeals.
  • Reinforcing Leadership’s confidence in the IT team by delivering on-time and within budget.
  • Resource Optimization by developing customizable Business rules.
  • Removal of the Payment variances by configuring batch Jobs.
  • Remodeling the process to configure payment posters with flexibility to categorize codes.