
About the Client
A subsidiary of a giant wholesale drug distributor is one of the largest US providers of pharmaceuticals, infusion therapy and other services to long-term-care and residential facilities such as nursing homes and specialty hospitals. The company also makes home deliveries and its institutional pharmacies serve innumerable patients in and across the US. Besides this, the company offers mail-order services, software and a website where carriers can access referral information and patients can order prescription refills or medical equipment.
Business Need
The company wanted to enforce compliance with HIPAA (Health Insurance Portability and Accountability Act) rules and the key area here was the Individual Rights System. The company therefore wanted a Microsoft .Net application to provide business users the facility to maintain and inquire various Member Rights Information and Disclosure Tracking Details.
Challenges and Requirements
Infosys' Role
The Infosys team, consisting of around 27 personnel, spent 14 months implementing the project. To ensure that a system that completely matched the client's specifications was created, Infosys used the Global Delivery Model to cut costs and ensure high efficiency. The .Net solution provided by Infosys included both online accessibility and batch processes that optimized the processing of the raw data.
The system supported tracking the Individual Rights and Disclosures of all Members and Applicants. The application scope covered a variety of member rights like Authorizations, Confidential communication, Disclosure Accounting, Access Request, Access Denial, Access Appeal, Amend Request, Amend Denial, Amend Appeal, Complaints, Objections, Restrictions, Marketing Opt-In, etc. The application also generated several predefined reports.
Benefits
The .Net solution that Infosys created for the client provided the following benefits:
Most importantly, the demonstrator proved beyond a shadow of doubt that tangible benefits could be accrued by modernizing healthcare and showed that the experiments could be reproduced nation-wide
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