Case Study: HealthRules® Promote Empowers Medica Health Plan to Streamline Processes
Large non-profit health insurance provider helps create a more efficient way to manage complex configurations and multiple instances of HealthRules Payer.
Medica’s Rapid Expansion and the Challenges of Managing CAPS
Medica, a large non-profit health insurance provider based in Minnesota, has experienced rapid growth, expanding its operations from four to twelve states within six years. This expansion introduced complexities in managing their core administrative processing system (CAPS), HealthRules® Payer from HealthEdge®. To address these challenges, Medica collaborated with HealthEdge to implement HealthRules® Promote, a web-based application designed to streamline the management of multiple HealthRules Payer instances.
HealthRules Promote has empowered Medica to manage over 70,000 configuration assets more efficiently, reducing administrative burdens and improving system audits. The platform enables Medica to control and understand configuration dependencies, minimizing errors and preventing disruptions in claims processing. This collaboration has led to significant time savings, error reduction, and enhanced audit capabilities, ultimately supporting Medica's growth and maintaining high-quality services.
HealthRules Promote: A Crucial Tool for Health Insurance Providers
The success of HealthRules Promote demonstrates its potential as a crucial tool for other health insurance providers looking to enhance efficiency and quality in complex, multi-instance environments.
Key Benefits of HealthRules Promote
- Streamlined Processes: Reduces time spent on issue research and resolution by eliminating the need for manual tracking and imports.
- Enhanced Quality Control: Minimizes the risk of early promotion of configurations, ensuring all dependencies are considered.
- Error Reduction: Confidently migrates configurations without errors, preventing production issues.
- Improved Audits: Facilitates easier audits and issue identification through dependency and compare features.
By leveraging HealthRules Promote, Medica has successfully navigated the complexities associated with rapid growth, setting a benchmark for efficiency and quality in the health insurance industry.
