Pediatrix Medical Claims Reporting is 80% Faster with Data Integration
Company Size
1,000+
Region
- America
Country
- United States
Product
- Actian DataConnect
Tech Stack
- Data Integration
Implementation Scale
- Enterprise-wide Deployment
Impact Metrics
- Cost Savings
- Productivity Improvements
Technology Category
- Platform as a Service (PaaS) - Data Management Platforms
Applicable Industries
- Healthcare & Hospitals
Applicable Functions
- Business Operation
Use Cases
- Automated Disease Diagnosis
- Regulatory Compliance Monitoring
Services
- Data Science Services
About The 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.
The 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.
The 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.
Operational Impact
Quantitative Benefit
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