INDUSTRY: Healthcare
COMPANY SIZE: 500 - 1000 Employees
HEADQUARTERS: Illinois, USA
While Experity Health's suite of software and services platforms provides flexibility to handle a client's unique needs, this wasn't always the case for their Revenue Cycle Management (RCM) platform. Previously, the extensive planning and effort required to implement changes limited the RCM platform flexibility. With each update, the platform's complexity increased and needed additional time for testing. Experity Health realized a new approach to the RCM architecture was required to reduce the time to reimburse clinics.
Axcelinno's professional services collaborated with Experity Health and delivered a platform based on Red Hat Decision Manager, Red Hat Fuse, and Red Hat AMQ. Throughout the engagement, Axcelinno's hands-on, mentoring-based approach upskilled the Experity Health team to ensure future success. Now, Experity Health has a flexible platform to meet customers' needs without additional complexity.
‘Complexities around RCM operation often prevent clinics from getting the quick reimbursement they deserve, so we were looking for a partner with deep technical expertise to work alongside our engineering team to deliver an optimized software solution. Axcellino stands out on top of the vendors list because of their vision and commitment to deliver a robust technical solution in a short period of time to meet our growing business needs.’
— Deven Shah, SVP, Software Engineering, Experity Health
Key Results
- Automated complex billing to reduce processing of 50,000 transactions to 1-2 hours.
- Reduced manual invoice process from 5 hours to minutes.
- Quickly adapt to healthcare regulations to ensure compliance.
- Deploy changes to customers in a matter of hours instead of weeks.
Services & Partner Ecosystem Technologies
- Axcelinno Professional Services
- Red Hat Decision Manager
- Red Hat AMQ
- Red Hat Fuse
Challenge: Mitigating Manual Processes
Due to the original architecture, implementation of the business rules, and integration with other software solutions, Experity Health experienced lengthy processing times due to the manual effort required to process claims. The processing time led to delays and prevented the RCM platform from scaling to meet strategic business goals. Based on the challenges Experity Health faced, it was evident that the RCM platform required a new architecture and refactoring.
‘There were definitely some road bumps and complications we came across throughout the process based on clients' requests and things that needed to get done. Despite those changes of plans, the partnership we had with Axcelinno was tremendous, and they, [the complications], ended up not even being road bumps. It was just a 'we have to take a left here.’
— Brandon Zweifel, Manager of Software Development, Experity Health
Solution: Deploy Red Hat’s Decision Manager To Align With Experity’s Goals
Experity Health partnered with Axcelinno and Red Hat to implement scalable business rules and integration solution that provides Experity Health the flexibility necessary to meet customer needs. The platform was required to decrease manual processes, reduce errors, and meet increased business demand for Experity Health's core products to meet customer needs.
The new RCM solution has accelerated the pace at which Experity Health delivers updates and new features to customers—while also increasing the collaboration among Experity Health teams. Standardizing on Red Hat software helps Experity Health's IT teams ensure updates to RCM are not only made quickly but with minimal risk of errors or outages for end users. Its new RCM platform's efficiency has helped Experity Health reduce its operational expenditure, including time savings and support costs.
Axcelinno implemented a robust, flexible platform using Red Hat Decision Manager, Red Hat Fuse, and Red Hat AMQ. Red Hat Decision Manager provides Experity Health the ability to quickly and easily define rules to evaluate medical procedure codes and billing codes to provide accurate billing. Red Hat Fuse and Red Hat AMQ allows Experity Health to integrate multiple systems to ensure data flows between systems quickly with the required availability.
Axcelinno's dedicated team mentored the Experity Health team on business rule best practices and implementation. Axcelinno created an open, highly collaborative atmosphere for the Experity Health team to ask questions and ensure they are equipped with the knowledge and skills needed for long-term success.
‘Working with Axcelinno and having that knowledge transfer, what every single little detail is, was very key. We were able to work closely with the Axcelinno team to not only develop the system but also take it all the way to QA and Production with their collaboration.’
— Brandon Zweifel, Manager of Software Development, Experity Health
Results
With the new Red Hat solution and support from Axcelinno's professional services, the Experity Health RCM platform delivers value to Experity Health customers faster, with improved performance and stability. Using Red Hat Decision Manager, Red Hat Fuse, and Red Hat AMQ, the RCM platform automates medical claims processing using business rule automation. The updated solution has allowed Experity Health to reduce the time required to process invoices to a matter of seconds from four hours per clinic.
With the RCM platform changes, Experity Health continues to be a leading provider of software solutions for urgent care centers and provides innovative solutions focused on customer care.
‘[Our team] used to spend every morning processing billing information for their practice. Red Hat Decision Manager completes that same work in minutes.’
— Brandon Zweifel, Manager of Software Development, Experity Health
About Experity Health
Experity Health, an industry-leading software, and services company focused on urgent care software solutions, helps its clients grow, thrive, evolve - and succeed. Experity Health’s purpose-built urgent care EMR platform allows clients to deliver on the promise of people-first healthcare. Experity Health is working with over 5,800 urgent care clinics to drive unprecedented patient experiences, elevate provider satisfaction, and chart a course into the future.
