Case Study: MediStreams

From ‘Survive’ to ‘Thrive’: Harnessing Back Office Power To Achieve & Accelerate Growth Case Study: Medical Payments Processing

98.5% ACCURACY

MediStreams is a leading U.S. healthcare revenue cycle management company, which focuses on reducing costs, increase efficiencies and maintaining compliance for its partners. Its revolutionary and efficient onboarding configurator sets them apart from similar vendors, and their security and throughput far exceeds government regulatory standards.

Before DDC, MediStreams’ processing system rested in the hands of one vendor and produced mediocre results. In addition to a need for diversification for disaster recovery and business continuity’s sake, the client also required a vendor that would equip its team with stronger efficiencies, higher quality data and improved turnaround time. Additionally, MediStreams wanted a vendor who would act as an innovative partner that would be able to integrate with its technologies, scale as volumes increase, and, of course, be trusted to always offer a fair price.

The Solution DDC designed a unique back office solution that achieves the above goals for multiple functions of MediStreams’ back office operation. Performed within both custom-built and client-owned systems, the services performed by MediStreams’ dedicated team of operators include: End-to-end EOB Processing, Patient Pay/Payer Mapping and customer-specific Correspondence Indexing services to be industry leading.

DDC processes approximately 132,000 EOBs per month with data capture accuracy guaranteed at 98.5% or higher within a 24-hour turnaround time frame.

The ‘tailor made’ technology developed to meet the client’s specific needs for EOB Processing also includes post-processing clerical and quality assurance services for MediStreams’ best-in-class remittance process offering. Inside this program, the client’s service team processes images in all critical levels, enter line items and balance data with the according checks. Once all data is adjusted andconfirmed, DDC’s staff sends the data back to MediStreams via XML.

Key Learnings In addition to the higher quality data, dependable turn around time and open lines of communication, MediStreams has also gained valuable insight into how their EOBs are being processed by its other vendors. DDC project leaders noticed early on that if a field is denied, a data entry operator could simply put in CO45 and pass it through the system despite the discrepancy. DDC, however, takes the time to determine the correct code for each field to ensure correct data. This has allowed MediStreams to meet deadlines, eliminate data discrepancies, and increase success rates with clients tremendously.

Additionally, a bug was discovered which incorrectly matched returning keyed EOB files to other providers.

DDC and MediStreams worked diligently together for a resolution. DDC managed to pinpoint the origin of the glitch and advised MediStreams to add the Provider ID to their claim xml tag. By our collective efforts, the matter was resolved and the client resumed successful service delivery to its customers.

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The Client Says “We are very pleased with the project and the team at DDC. The software written by DDC’s VP of IT is very impressive and sped up the rate of output from the beginning.

Our dedicated project manager is responsive, diligent and accessible. She and her data entry team have improved the quality of our data and turn around time so that we are able to exceed our deadlines. Most importantly, we trust DDC. The difference between this partner and our other vendor is night and day.”