The client arranges for the provision of care, equipment, medications, medical supplies, and other ancillary health services to injured workers. Their high-touch care coordination connects claimants with providers and facilitates the delivery of home health services. Workers’ comp reimbursements are extremely complex, and through constant stewardship and management of services, customers are saved thousands in medical expenses while receiving the coverage they deserve.
The organization was relying on a legacy system to facilitate day-to-day business operations, but the software’s capabilities had become misaligned with current business needs. Written in Act, the system served the needs of CRM but hampered care coordination and communication across the team. It couldn’t model new care workflows and, due to a prohibitive billing model change, couldn’t be rolled out to new staff.
Gavant conducted a collaborative review of the workflows with internal stakeholders and built a HIPAA-compliant software platform on AWS. The modernized application realigned workflows with specific staff needs and enabled all departments to be coordinated on the services and billing processes affecting patients, vendors, and providers. Additionally, a new mobile-responsive portal and mobile app enabled case managers and adjusters to view patient information and status updates in realtime.
The new application has transformed internal operating efficiency through visibility, collaboration, and reporting. Users can more easily track services provided to patients, which in turn enables more accurate and streamlined billing. And automations around service activities have completely supplanted weekly recurring processes. With the addition of external-facing mobile access, partners within their network have direct visibility of information that previously required time-consuming phone calls and form requests.