An international managed care company undertakes an EHR integration using Apex's EHR expertise.
SITUATION
Our client has the means to extract patient population profile information directly from provider EMRs in an electronic format to automatically generate a patient population risk profile. The aggregated risk profile generates a health risk score for the client’s health plans, which then determines the reimbursement amount from Medicare and Medicaid. The EHR integration our client needed required a partner to provide content and collateral for internal teams, training, workflows, and SOPs as well as establish external content aligned to their brand, playbooks, workflows, and a SharePoint site. Finally, our client was looking for a partner to have co-ownership of the project where they would only need to give guidance since our client could not manage their needed volume.
Over 8,000 Provider Implementations Completed
The engagement involved Apex maturing the client’s electronic network and reaching out to approximately 8,000 physician offices to enroll in this network. The business value of the engagement centered around maturing the operational procedures of the client’s electronic connectivity network, advancing the analytics reporting of the program, and growing the number of direct electronic connections with physician offices.
RESULT
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Identification and roll out of team lead structure to ensure streamlined process with stakeholders.
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Handled over 4,000 project entries, over 800 meetings scheduled with providers, and submitted quality data entry within a high-volume environment.
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Over 16,000 NPI's identified as potential new provider targets.
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Built out SharePoint internal and external site, 2024 Health Plan Playbook, EHR program Road Map, Healow standard operating and implementation procedures.
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Built integration SSI packages with GIT lab repository for source control. This was developed to promote code changes from development to production.
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Created an Active Members Records database from various sources which included members eligibility span, members’ address, information, plan code, and plan type.
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Created a trending report which included automating archiving tables daily, comparing archive data at an aggregate level, allowing drill-down capabilities, comparing and aging on issues and status.
