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.