Healthcare IT Vendors Solutions

A robust RCM solution for an EHR provider based out of Michigan

A leading provider of Electronic Health Records (EHR) primarily catering to podiatrists, based out of Michigan catering to more than 2000 clinics across the US, was looking to build a robust Practice management & RCM solution spanning multiple workflows that seamlessly integrates with the current EHR.

Client Challenge

The client envisioned an RCM solution that can be offered as an independent plug and play service integrated with any EHR, while also supporting the in-house EHR system.. They wanted to cover many administrative and financial workflows such as Patient Intake, scheduling, eligibility checks, prior authorizations, claim cycle, resubmissions, COBs, remit posting, denial manager, billing reports, dashboards etc. The objective was to introduce transparency for quick edits, update providers with every possible claim edit, seek approvals from billing supervisors & providers, reduce the claims TAT and improve receivables.

Solutions

Nalashaa Team designed and developed a solution that offers performance and scalability expected by the end users. The solution leverages MS Azure feature-set to accelerate development, ease maintenance, enable painless deployments/activations and provide scalability among other things.

The solution leverages Azure AD’s user-store with claims-based authentication over OAuth2.0 and the Multi-Factor Authentication (MFA) capability. Web Apps, API with Deployment slots and TLS 1.2 security enabled accelerates the entire deployment process and the latest CI-CD tools enable faster release cycles. No manual intervention required to configure web servers like IIS and use of Deployment slots imply quicker activations for the client.

Below are a few technical features of the solution:

Storage: Azure Blob storage and Azure Table Storage offer great security via Shared Access Signatures and flexible scaling options.

Asynchrony: Azure Queues are used for asynchronous transactions for email and logs.

Database: SQL Azure on elastic pool which is very cost affective for large number of databases with varying storage space requirements.

Continuous Integration and Deployment: VSTS

Email: Send-grid which offers SMTP server as a service

Batch processing: Web Jobs

API: Azure API management

Cache: Azure Redis Cache

Applications: MVC layer, Web-API and angular JS

Improved RCM staff productivity through workflow automation and superior User Experience

Deeper insights via Actionable dashboards- Claim Manager / Denial Manager made resubmissions and COBs flow seamless

With real-time eligibilities/authorizations, denials related to coverage, service limits and accuracy (provider and patient details) are reduced, improving cash flows.

Technology Stack

  • Angular JS 1.6.2
  • HTML 5
  • Dot Net Framework 4.6
  • Entity Framework 6.X
  • ASP.Net Identity
  • OAuth 2.0
  • Web API 2
  • SQL Server Standard
  • Azure Cloud
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