Case Study
Benefits Inquiry Solution with Azure Logic Apps
Business Application Integration Development Case Study
Industry
Healthcare
Solution
Application Development & Integration
The Client
Founded in 2005, HealthSun is a local Medicare Managed Care Organization with administrative offices located in Coconut Grove, Florida. Serving more than 40,000 Medicare Advantage consumers in Miami-Dade and Broward counties through its network of 19 wholly owned primary care and specialty centers, HealthSun is one of the fastest-growing health plans in South Florida.
Business Challenge
- Meeting CMS Guidelines: HealthSun faced the challenge of implementing a CMS-mandated standardized benefits inquiry system within a tight timeframe, ensuring federal compliance.
- Adopting Cloud Technology: Transitioning to cloud technology was necessary to minimize costs and enhance operational efficiency, presenting a significant challenge for HealthSun.
- Ensuring Encrypted HPI Communication: Implementing secure HPI communication via encrypted channels to align with CAQH Phase II rules was essential for data confidentiality and compliance.
- Streamlining Implementation: HealthSun needed to establish a manageable system within the CMS time frame, ensuring long-term compliance and operational efficiency.
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