Strategic Planning & Business Development Teams

Use Case: Your strategic planning team can use the dashboard to assess regional payer enrollment figures, helping identify high-coverage payers and geographic areas for potential expansion of service lines or partnerships. This data supports informed decisions on resource allocation and growth opportunities.

Contract Management Team

Use Case: Your contract managers can leverage payer enrollment data to prioritize contract negotiations with high-enrollment payers, ensuring they are focusing on payers that cover a significant portion of the local patient population. This helps secure better terms and expand patient access to your services.

Revenue Cycle Management Team

Use Case: Your revenue cycle team can use the dashboard to identify top payers by enrollment, helping to align resources and focus efforts on resolving issues with payers that represent the largest patient populations. This data-driven approach can streamline claims processes and improve reimbursement rates.

Population Health Management Team

Use Case: Your population health team can analyze payer enrollment data by plan type and geography to better understand the coverage landscape and identify gaps in patient access. This information can be used to tailor care coordination efforts and improve patient outcomes by targeting interventions based on coverage trends.

Provider Relations & Network Development Team

Use Case: Your provider relations team can use enrollment figures to evaluate the network strength of key payers in specific regions. This data helps assess which payers to engage for network participation, ensuring alignment with those that have substantial patient coverage in your service areas.

Same application as above. 

• Strategic Planning & Business Development Teams
• Contract Management Team
• Revenue Cycle Management Team
• Population Health Management Team
• Provider Relations & Network Development Team

Provider Systems: Epic

Payer Portals: OnBase, Epic

Challenge:

A large Mid-West Healthcare provider with fifteen hospitals across two states had a large document processing problem: importing Patient Consent Forms into OnBase. This is generally not an issue for most DU (Document Understanding) tools because most of the data is structured. In this case these particular documents included a stamp or label of patient demographics added by hand and placed on the document with both structured and unstructured data. This information on these labels then needed to be read and indexed into Epic. The challenge was that these labels were being placed on the documents by clinicians and in most cases were not always positioned in a way that was effectively “read” by most DU tools.

Solution:

As a trusted adviser to the client, CampTek Software brought in several DU vendors to perform a proof of concept for the provider so they could evaluate the ability of several tools to effectively read the skewed labels. Document Understanding solutions such as ABBYY, UiPath and Indico were among those reviewed.

Each product was given a sample set of documents as part of a proof of concept. From there, CampTek would analyze the ability and percentage results to present back to the client. The findings were overwhelmingly positive for Indico. Even upside down, the labels could be read immediately. For others, the test proved that if the label was more than 10% out of alignment, they had poor results. Indico immediately showed a 90% accuracy result. Indico also did not require the use of templates, like some of the other tools did.

The findings were presented to the customer and within a short time the project was approved. Also, it was stated by the project lead that once this first project was implemented, there will be additional opportunities for expansion of the Indico/CampTek managed services solution. For example, the ability to pull data and documents from Legacy systems like CPSI and replacing expensive point solutions like Edco Solarity as next projects.

• 7.4m documents first year requirements
• Hospital 1: 600/hour average (Tuesdays are the heaviest day week).
• Hospital 2: 320/hour (Tuesdays are the heaviest day week). 500-400 documents per hour per process (4 processes)
• Average file size, twenty pages or less

Any Healthcare provider