Actian Case Studies Pediatrix Medical Claims Reporting is 80% Faster with Data Integration

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	Pediatrix Medical Claims Reporting is 80% Faster with Data Integration Actian

Pediatrix Medical Claims Reporting is 80% Faster with Data Integration

Actian

Technology Category	Platform as a Service (PaaS) - Data Management Platforms
Applicable Industries	Healthcare & Hospitals
Applicable Functions	Business Operation
Use Cases	Regulatory Compliance Monitoring Automated Disease Diagnosis
Services	Data Science Services
Challenge	Pediatrix Medical Group, a leading provider of maternal-fetal, newborn, and pediatric sub-specialty physician services, was facing significant challenges in its claims processing due to lack of data integration. The company works with multiple clearinghouses for insurance claims and receiving claims status reports, each of which employs unique and complex formats in generating reports. The lack of data integration between internal applications and clearinghouses caused breaks in information flow, slowing down the claims review and reporting process, and creating a disconnect between reporting and other process steps in the Pediatrix patient life cycle. As the volume of the claims increased, these challenges grew more severe, causing bottlenecks and delays in insurance claims processing. Read More
About Customer	Pediatrix Medical Group was founded in 1979 and has grown to become America’s leading provider of maternal-fetal, newborn, and pediatric sub-specialty physician services. The company is supported by clinicians and business professionals in a collaborative effort to provide the best patient services, backed by ongoing research, education, and quality improvement initiatives. This requires a flexible and scalable healthcare IT environment in which large volumes of disparate data can be managed with speed and efficiently. In the early 2000s, Pediatrix foresaw the need for heightened technology to manage the complexity and scale of big data in the rapidly changing healthcare environment and teamed up with Actian, adopting Actian DataConnect™ to address this challenge. Read More
Solution	Pediatrix adopted Actian DataConnect to automate its end-to-end claims processing. Actian DataConnect allowed Pediatrix to integrate, migrate, sync, validate, standardize, and enrich all of its claims data on a single platform. This improved claims reviews and reporting while integrating this step with other business-critical processes. Actian DataConnect established an event-driven, message-based infrastructure on which the company can connect to any data with greater visibility and control of the data integration environment. It transforms all the data and presents it as a single database table, reducing the time, resources, and risk of error involved in reporting, especially when medical claims are rejected and reports indicate that they must be resubmitted. Read More Log in to view content
Contents

Technology Category

Platform as a Service (PaaS) - Data Management Platforms

Applicable Industries

Healthcare & Hospitals

Applicable Functions

Business Operation

Use Cases

Regulatory Compliance Monitoring

Automated Disease Diagnosis

Services

Data Science Services

Challenge

Pediatrix Medical Group, a leading provider of maternal-fetal, newborn, and pediatric sub-specialty physician services, was facing significant challenges in its claims processing due to lack of data integration. The company works with multiple clearinghouses for insurance claims and receiving claims status reports, each of which employs unique and complex formats in generating reports. The lack of data integration between internal applications and clearinghouses caused breaks in information flow, slowing down the claims review and reporting process, and creating a disconnect between reporting and other process steps in the Pediatrix patient life cycle. As the volume of the claims increased, these challenges grew more severe, causing bottlenecks and delays in insurance claims processing.

About Customer

Pediatrix Medical Group was founded in 1979 and has grown to become America’s leading provider of maternal-fetal, newborn, and pediatric sub-specialty physician services. The company is supported by clinicians and business professionals in a collaborative effort to provide the best patient services, backed by ongoing research, education, and quality improvement initiatives. This requires a flexible and scalable healthcare IT environment in which large volumes of disparate data can be managed with speed and efficiently. In the early 2000s, Pediatrix foresaw the need for heightened technology to manage the complexity and scale of big data in the rapidly changing healthcare environment and teamed up with Actian, adopting Actian DataConnect™ to address this challenge.

Solution

Pediatrix adopted Actian DataConnect to automate its end-to-end claims processing. Actian DataConnect allowed Pediatrix to integrate, migrate, sync, validate, standardize, and enrich all of its claims data on a single platform. This improved claims reviews and reporting while integrating this step with other business-critical processes. Actian DataConnect established an event-driven, message-based infrastructure on which the company can connect to any data with greater visibility and control of the data integration environment. It transforms all the data and presents it as a single database table, reducing the time, resources, and risk of error involved in reporting, especially when medical claims are rejected and reports indicate that they must be resubmitted.

Impact #1	Actian DataConnect provides Pediatrix developers with a highly productive visual design environment to print process flow charts, see how a process works, and add comments.
Impact #2	By documenting code as they go, Actian DataConnect promotes reusability and eliminates the time and cost of maintaining custom coding.
Impact #3	Actian DataConnect simplifies and speeds new integrations through dynamic discovery of field metadata and customizations.

Impact #1

Actian DataConnect provides Pediatrix developers with a highly productive visual design environment to print process flow charts, see how a process works, and add comments.

Impact #2

By documenting code as they go, Actian DataConnect promotes reusability and eliminates the time and cost of maintaining custom coding.

Impact #3

Actian DataConnect simplifies and speeds new integrations through dynamic discovery of field metadata and customizations.

Benefit #1	Reduced medical insurance claims reporting time by as much as 80 percent, running reports in as little as five minutes.
Benefit #2	Reduced the time to resubmit claims rejections.
Benefit #3	Reports now can be posted automatically to Accounts Receivable for quicker turnaround on payments.

Benefit #1

Reduced medical insurance claims reporting time by as much as 80 percent, running reports in as little as five minutes.

Benefit #2

Reduced the time to resubmit claims rejections.

Benefit #3

Reports now can be posted automatically to Accounts Receivable for quicker turnaround on payments.

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Overview

Pediatrix Medical Claims Reporting is 80% Faster with Data Integration

Operational Impact

Quantitative Benefit