KPi-Tech's transformative impact was felt by a prominent healthcare provider as we automated complex payer risk contract management. By optimizing patient data processing and elevating healthcare quality, we redefined operational excellence.
Vertical:
Healthcare Technology
Region:
USA
Challenge:
Automating the process of adding or removing "Risk Contract" banners for eligible patients, previously a manual and resource-intensive endeavor.
Introduction
Business Need
Efficiently managing payer risk contracts was our client's aspiration. These contracts entail healthcare providers assuming the mantle of managing healthcare costs and quality for specific patient groups. The aspiration was to automate contract management, ensuring precise patient identification, seamless integration, streamlined care coordination, and ultimately, improved patient outcomes.
The business need was to automate the management of payer risk contracts, ensuring accurate identification of eligible patients and seamless integration of these contracts into the healthcare system. This would facilitate better care coordination, resource allocation, and patient outcomes.
Challenges
Solution
The solution hinged on crafting a bespoke automated process utilizing Talend Studio:
- Automated Talend Job:A meticulously designed Talend job was conceived, poised to spring into action upon data receipt from the insurance company.
- Data Processing: The Talend job seamlessly extracted patient data from incoming files and seamlessly populated records in the database, bidding farewell to manual data entry and error vulnerabilities.
- Archival of Processed Data:Processed data was elegantly archived, embracing meticulous record-keeping and prudent data management practices.
- API Synergy:Our solution effortlessly harmonized with pertinent APIs. It not only engaged the Insurance API to procure a requisite Access Token but also seamlessly interacted with the Risk Contract API for detail updates.
- Enhanced Patient Scrutiny:Precision-defined enhanced patient searches ensured eligibility for the "Risk Contract."
- Robust Tracking and Reporting:An elaborate logging framework stood sentinel, capturing comprehensive transaction records for prospective referencing. A meticulous email report, meticulously detailing processing specifics, gracefully concluded each job cycle.
- Flawless Error Handling:The solution was fortified with an intricate web of error-handling mechanisms. Be it the absence of a patient record or the emergence of duplicate entries, appropriate error messages unfailingly found their place.
Solution Architecture
Tech Stack
Talend Studio, PostgreSQL
Achievements
The harmonious amalgamation of Talend job and APIs ushered in a paradigm shift, significantly slashing manual interventions, enhancing precision, and assuring accurate patient identification and management under the "Risk Contract." Notable accomplishments encompassed a remarkable reduction in processing timelines, transforming laborious hours into moments, and an astonishing 90% cut in overall processing duration, a testament to our heightened operational prowess.
Ready to elevate patient care and operational efficiency? Reach out to us today and embark on a journey towards a better healthcare future.
