UltimoSoft has built an international reputation in providing reliable, cost-efficient, and secure technology services in the Healthcare sector. As the only consulting partner of Edifecs, creators of a powerful set of Healthcare applications, tools and technologies, UltimoSoft is uniquely positioned to provide service leadership and expertise. We offer complete life cycle B2B implementations.
In concert with your organization, we provide the essential consulting link that removes barriers between Healthcare enterprises, optimizing your financial, administrative, reporting, compliance, and pharmaceutical digital data communications and cutting operating costs. UltimoSoft Healthcare experts help you define, monitor, troubleshoot, route, and record all your transactions.
Solve challenges in:
Electronic claims are submitted to CareFirst and CareFirst BlueChoice by physicians and hospitals through one of their preferred vendors or by billing agents, vendors, or clearinghouses. CareFirst has approximately eight trading partners, including Emdeon, MedAvant, MTrans, Payerpath, Per-Se Technologies, and Professional Management Group.
UltimoSoft is involved in building a B2B solution for Carefirst using TIBCO suite of products such as BusinessConnect, BusinessWorks and Adapters. This solution includes building Data warehousing and Business Intelligence reporting solution, SLA tracking for adjudication of claims, auditing services, error handling services, and duplicate detection processing. It is expected that this project will ensure faster and more accurate claims processing, resulting in higher customer satisfaction and better revenues.
Call Center Integration for Eligibility/Benefits/Claims inquiry
CareFrist uses Epiphany CRM for managing the call center. The eligibility, benefits and claims data is stored in different mainframe-based systems. There is need for integration of Epiphany CRM with several back-office systems for member data synchronization and Eligibility, Benefits and Claims inquires.
UltimoSoft is involved in building integration solution based on SOA architecture for integrating Epiphany with back-office systems. TIBCO products such as BusinessWorks and Adapters are being used for integration. This is a very high-volume and high-response requirement application. UltimoSoft provided Architecture, Design and Development services that include providing of Logical Architecture, Conceptual Architecture, Monitoring Strategy, Operations Strategy, Capacity Planning, and Deployment Strategy. It is expected that this project will improve the productivity of the call center representatives/consultants and better customer service.
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