Rhapsody Health Solutions Team

What Else Can I Do With My Interface Engine?

June 10, 2014

Now that you have a robust interface engine like Corepoint Integration Engine handling all or at least most of your message traffic, maybe it’s time to start thinking about what else the engine can do for you.

For example, many organizations leverage the engine to transport their healthcare claims to a clearinghouse for dissemination to payers. It makes lots of sense to engage the services of a clearinghouse since there are often 100s of different payers and maintaining connections with each would be an impractical and costly task. It may, however, be worth looking into the traffic patterns, or metrics, to see if there are some opportunities for consolidation or cost savings.

For example, as the claims are passing through the engine, you can keep track of all the different payers and the number of claims processed for each. This can be as easy as creating a two-column database table and a simple stored procedure for each message as it passes through the engine.

After a couple of months, go back and see if there are one or two payers that account for a majority of the traffic. Perhaps it makes sense to investigate setting up a dedicated connection to those one or two payers where the cost-per-claim is much lower than sending them through the clearinghouse (maybe even no cost after the initial connection is established). Or, maybe it doesn’t make business sense at all… at least now you know.

Often, opportunities arise simply by asking colleagues in other departments to identify their most time-consuming manual tasks. It is surprising how many processes still involve some variation of a “print/fax/scan” process. Hundreds of hours a year are spent converting files/documents/information from one format into another only to have someone else convert it back to the same or a similar format on the other end.

Even though there is the “that’s the way we’ve always done it” barrier to be overcome in any proposed change of procedure, the steps that can be reduced are often very monotonous and folks will buy in to the change to improve a tedious process.

The point is not to try to impose change for the sake of change itself, but rather to seek out the low-hanging fruit of process improvement and challenge the limitation of “traditional” engine functions.

“Now that I have all this data passing through the engine, what else can I do with it to make better patient and business decisions?”

What else are you doing with Corepoint Integration Engine? 

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