Practice Management
Solution Set
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PM Application Services
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Global Works Customizes EDI for Automated Enrollment at Virginia Premier
"We were able to update existing enrollment and enroll approximately 30,000 new members."
David Summers, Director, Systems Development, Virginia Premier Health Plan
Issue
As a result of a business change that would double their membership, Virginia Premier Health Plan, an HMO serving Virginia’s greater Richmond area, needed an efficient way to add 30,000 new members to their database. Their current, manual method of enrolling members would prevent a timely response to the expansion.
Solution
Virginia Premier chose to automate their enrollment procedure with EDI and selected Global Works Systems to guide the implementation. The project involved:
- creating custom files for new enrollment additions, PCP changes, and terminations
- implementation and customization of the IDX® EDI Toolkit
- custom member matching, contract matching, and cross-map dictionaries
Results
- 100% increase in enrollment within 60 days
- Manual enrollment converted to automated method, allowing for faster transaction processing and increased data accuracy
- Reduced overhead
IDX® is a registered trademark of IDX Systems Corporation.
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