Improved Outcomes and Reduced Expenses with AMISYS Advance™

THE CLIENT

Sitting in the top 25 Fortune 500 companies, and in the top 60 Fortune Global 500 companies, the client achieved explosive growth through aggressive acquisitions. They nearly doubled their footprint within a very short timeframe as well as bringing in a variety of new offerings to the healthcare market. Currently, one in 15 Americans are covered through the client’s managed care and payer services, and their 2022 revenues exceeded $144.5 million.

THE ISSUE

The client’s rapid expansion led to interoperability growing pains. The companies the client purchased were established on various platforms, requiring consolidation of claims operations and business lines to their current AMISYS Advance™ system. Internally developed solutions led to production problems and inconsistent cost share application to a large portion of the client’s product population. Additionally, costly adjudication failures and penalties were negatively impacting their revenue stream.

THE REMEDIATION

The client turned to Mediant to provide expertise and rapid solutions to costly challenges. They chose Mediant based on their reputation in and knowledge of the industry. Mediant provided in-depth expertise covering business analysis, systems architecture, and strategic advisory services.

Within two days of onboarding, Mediant rapidly assessed the underlying problems and provided a three-phase remediation plan to address the urgent needs while also developing a sustainable, scalable solution that could keep pace with the client’s meteoric growth. Two weeks after Mediant’s proposed remediation plan was accepted, the first phase was delivered to production.

Mediant was tasked with:

• Consolidating and migrating legacy systems into a manageable, scalable system that was capable of keeping pace with the client’s rapid growth
• Identifying, and acquiring the talent necessary to meet ongoing needs
• Provide expert training and development to the client’s internal team, positioning them for continued, long-term success

THE OUTCOME

Mediant’s involvement led to the development and successful completion of seven large scale projects and completions over six years which yielded impressive business health improvements.

Mediant’s expertise led to:

• The client being able to accurately reprocess 150,000 claims two weeks after accepting Mediant’s initial remediation plan
• Cost savings from avoided penalties and eliminated time spent reactively addressing system failures
• 30% improvement to business outcomes
• $25 million reduction in annual operating expenses

See how Mediant can help you meet your goals.