ingenioHq   contact us | connect with us:    twitter   linked in
healthcare industry services
→ overview
case studies

Learn more about LogiSolve's Healthcare Industry consulting experience:

 
ePrescription

LogiSolve is a world leader in delivering ePrescription solutions.

learn more 

featured solutions
 

Our ePrescribing Gateway Module is a toolset available to our customers for integrating with Surescripts for electronic prescribing. The component allows our customers to achieve connectivity and certification faster with less cost.

 

One of the many challenges in the healthcare revenue cycle management process is reconciling claim remits against cash received. CARS can help you better manage this process while providing tight integration to your existing claims processing and financial systems.

Healthcare Industry Services Overview

LogiSolve is an industry leader in healthcare consulting. We have nationally-recognized resources specializing in providing healthcare consulting leadership who have accomplished records of delivering critical business initiatives on time and within budget.

LogiSolve offers both solution/project-based services and strategic staff augmentation services. Our client list is a "Who's Who" in Minnesota Healthcare. LogiSolve also has been an active participant in national healthcare industry standards groups including HL7, x12, and NCPDP that have contributed to the development of the electronic standards used in the Healthcare Industry.

Unique Industry Expertise
  • Clinical Messaging (Clinical Interoperability)
  • Electronic Prescription (ePrescription) Services
  • Electronic Medical Record (EMR) Systems
  • HIPAA Compliance Projects
  • Healthcare Digitization
  • Insurance Billing and Claims Processing
  • Acquisition Absorption
  • Regulatory and Compliance
Our Healthcare Experience

The following are examples of Healthcare initiatives led by LogiSolve consultants:

Large Retail Clinic
Assist with the design and implementation of Clinical Messaging between physicians, payers, and pharmacies. Messaging is becoming more of a factor to assist with the overall care of the patient. When multiple parties are providing care for one patient, it is important that disparate systems can exchange information is a secure standard form. LogiSolve has experience in working within the clinical messaging model utilizing the standard transaction sets where they exist or proprietary standards where needed.

Multiple Parties
Currently assisting with the introduction of a electronic Prior Authorization (ePA) standard that will between Physicians and payers. The standard has been designed and has been introduced to NCPDP for review. LogiSolve assisted with this design and pilot of the new transaction set.

Fortune 500 Health Care Organization
Created, lead, and delivered an enterprise ePrescription solution, creating more accurate supply to patients, and improving internal efficiency within the process.  Learn more about LogiSolve's ePrescription Services

Major Hospital & Clinic System
Provided resources to help support EPIC software implementation to hospitals. LogiSolve performed User Training, Project Coordination and Systems Analysis.

Fortune 500 Health Care Insurer
Provided project leadership and connected business objectives with IT projects. This particular client was challenged with 1) unclear expectations between IT and the business regarding technical project delivery, 2) timelines and cost, 3) business objectives and project requirements alignment, and 4) decision-making role definition. LogiSolve provided facilitation and role clarification, as well as developed a process clarifying roles on the front end of the project, which greatly diminished issues downstream.

Fortune 500 Health Care Insurer
Integration of disjointed systems resulting from recent acquisitions. This client had grown significantly through acquisition over the previous 3 years. With that growth came disparate systems, processes, and cultures. LogiSolve developed a technical plan to select best of breed capabilities for the new organization.

Retail Pharmacy
Delivered an enterprise ePrescribing solution in multiple areas of the organization. The LogiSolve team established connectivity between the ambulatory care system and key trading parties to allow for the exchange of script information, retrieval of formulary and medication information, and the determination of eligibility benefits. The project included the scope definition, requirements analysis, design, development, and QA. Once complete, the team achieved certification status with both RxHub and SureScripts.

Fortune 100 Health Care Insurer
Conducted an assessment and made recommendations for improving a client/physician portal that had performance and navigation issues.

Large Retail Clinic
Provided electronic prescribing expertise. The LogiSolve team developed a solution to connect the current EMR application to SureScripts to provide connectivity for the exchange of electronic scripts. The LogiSolve team achieved certification with SureScripts allowing for connection to all interested pharmacy vendors. The LogiSolve team also implemented various other features enhancing the prescribing process and providing necessary medication information during the prescription writing steps.

Fortune 100 Health Care Insurer
Worked with the executive team to identify, assess, and aggregate critical business information such as customer demographics, geographic areas of growth, service line cost and profit trends.

Health Information Network
Provided resources to the transaction hub during the early months of their inception. The client utilized LogiSolve’s expertise in Project Management, Business Analysis, and Technical Architecture to assist with the definition and design of the network. The solution involved the creation of a Hub that would be utilized by PBM’s, clinical vendors, and pharmacies for the exchange of medication related information. Resources served a number of roles throughout the project including the definition of the utilized standards, certification of connected participants, architectural design of the solution, and implementations.

Fortune 500 Health Care Insurer
Worked with the executive team of this major behavioral health organization to validate their strategic planning process and draft Corporate Performance Management Metrics based on their top 10-15 business drivers.

LTC Software Vendor
Provided electronic prescribing expertise. LogiSolve supplied business analysis, project management, and technical resources to assist in completing a CMS-sponsored pilot proving the value of standards within the electronic prescribing space.

Fortune 500 Health Care Insurer
Directed a care management application integrating data into our client's Data Warehouse including workflow and processes around care authorization. LogiSolve provided leadership in Data Architecture and Project Management.

Fortune 100 Health Care Insurer
Provided program direction for an Enterprise Billing Initiative replacing over 20 disparate legacy billing systems across the enterprise into a centralized SAP billing solution. Provided strategic project leadership resources to the initiative in the area of project management, business analysis, development architecture, and QA on an as-needed basis.

Fortune 500 Health Care Insurer
Provided Business Analysis consulting services on a variety of corporate initiatives and mandates including; 1) National Provider ID, 2) Customer Portals: various projects (Analysis and Technical Architecture), 3) Diagnostic Imaging, and 4) Select Account Re-plat forming Initiative.

Pharmaceutical Management Branch (PMB)
Performed clinical vendor certifications. The LogiSolve team performed test cases analysis of the clinical system to ensure they were complying with the client’s requirements around electronic prescribing, formulary display, medication history retrieval and refill processing.

Consortium of Medication Distribution Companies
Provided Application Architects, Object mModelers, Business Analysts, Quality Assurance, and other technical resources for the healthcare-related company formed by the consortium. The company was developing a contract management system that would be utilized by a variety of companies in the health care supplies and pharmaceutical supply chain. LogiSolve utilized the Rational Unified Process and the TogetherSoft Control Center process-modeling tool to perform analysis and design tasks for the project. LogiSolve also served as a liaison between the client and a third party firm that would be developing the business object components, facilitating design sessions between the two parties.

Fortune 100 Healthcare Organization
Provided a Senior Project Manager and a Senior Business Analyst to manage a merger-related system integration project. The purpose of this project was to migrate and consolidate healthcare plan enrollment and billing functionality from 2 legacy systems to a single platform. A LogiSolve project manager and business analyst were engaged to develop and launch a program organizational structure, charter, project plan, and SharePoint site for enrollment, billing, and customer services functions. LogiSolve resources were responsible for managing the project to migrate enrollment business processes and data from three systems to a single consolidated system. A gap analysis was completed to identify gap mitigation strategy and process. In addition, LogiSolve’s resources managed the development of process instructions, use cases, policies, and procedures, reports, and fulfillment. The project was managed through user acceptance testing and planning for production acceptance testing, system cutover and migration.

Fortune 100 Healthcare Organization
Managed two projects implementing Healthcare mandates for a late enrollment penalty on plans with a lapse in coverage and low income subsidies for low income membership. This process included the implementation of a Productivity Tracking Tool (SQL) for resource report tracking. Ongoing responsibilities included the creation and management of a project plan, facilitating project meetings and recaps, process improvement and documentation, issues management, and compliance support and approval.

Minnesota Healthcare Organization
Managed multiple projects for the Enterprise Delivery Project Management Office and launched a call center physical move. Both projects included aligning and managing cross-functional operations, with strict timelines across multiple physical sites within the enterprise. LogiSolve’s project manager worked collaboratively with the business partner stakeholders to provide assistance with planning, project prioritization, and best practice management solutions.

Fortune 100 Health Care Insurer
Designed and implemented an intake process to capture all requests coming through its Enterprise Services organization which, among others, included Sales, Call Centers, Member Relations, Billing, Enrollment, Claims and Vendor Relations. A Senior LogiSolve Consultant was brought in as a Project/Program Manager to oversee the design and implementation of a solution so that all requests were captured appropriately, reviewed by an executive Review Team, categorized, and assigned to the appropriate resource(s) for resolution. LogiSolve's resource worked with different groups within Enterprise Services to design, build and implement a solution. The solution allowed management to have a formal process to address the needs of the business by better understanding the requests coming though the organization and the demand on resources required to address the requests. After the implementation, LogiSolve’s resource managed the process and worked with management to transition to the client's internal resources.

Major Minnesota Health Insurance Organization
Lead and managed a group of annual projects preparing all Business Units for open enrollment. LogiSolve managed a variety of projects for the Telesales Business Unit. Our Project Manager led all projects that involved the Dialers (Avaya, Melita, Timber), and focused on all initiatives that included inbound and outbound calls. This included running a weekly Dialer meeting, getting new campaigns set up on the Dialer, and keeping track of all issues surrounding the Dialer. In addition, our resource managed a project that included managing an outside vendor to implement a GUI overlay to aid users with a lead-tracking application in addition to managing a project to implement Digital Signage Boards in all Call Centers. Both of these projects not only included being the point person for the vendors, but also being the IT liaison within the client for both projects, along with overall project management of both. Our resource served as the main contact and coordinator for the Telesales Field Sales Training, which encompassed 500 agents and about 20 presenters across three nationally-disbursed sites. Our Project Manager also served as the primary contact for the 2008/2009 Readiness project for the Telesales Business Unit.

International Health Insurance Organization
Responsible for facilitating, managing and implementing new processes simultaneous with change management and system implementation. The projects incorporated functional areas from the Call Center to Appeals and Grievances. Managed three internal projects considered critically urgent and sensitive in nature. Other responsibilities included mitigating risk through streamlining mailboxes to create an effective process for escalating Appeal and Grievance issues, managing projects to comply with state and federal regulations, working with virtual project teams, developing processes and maps for the Quality of Care project to maintain compliance and implement them simultaneously with change management for multiple functional areas, identifying and documenting operational impacts and process gaps with business partners for a highly visible system implementation project, managing the full project delivery, monitoring quality and budget, planning project deliverables and project schedules, resolving issues, allocating resources, directing staff and other resources to accomplish project tasks, and assisting the Project Management Office in implementing project management lifecycle and documentation standards.

A $30 billion Healthcare Enterprise
Delivered an Information Management Strategy. After several years of intense business acquisition, our customer's application and data landscape had become extremely complex and convoluted. Their assets included several formal analytic warehouses and marts, and scores of offline spreadmarts. Having almost no process for capturing metadata, or performing master data management, analysts spent nearly half their time integrating data and applying business rules on their desktops. Repository redundancies further complicated these tasks, creating several versions of analytic “truth”, and mis-directing business decision making. Over a three month period, LogiSolve worked with the enterprise to bring clarity and direction to a frustrated information community. Delivery included a detailed assessment of the current state architecture, a conceptual future state vision, and a strategic roadmap describing how to move from point A to point B. The strategic roadmap offered long-term objectives, while also solving short-term, tactical needs. The roadmap also called for the creation of an Information Governance Council to oversee execution and maintenance of the Information Management Strategy. The LogiSolve project team consisted of two senior level Data Warehouse/BI Subject Matter Experts and Program Managers. The client has since asked us to assist with the implementation of our recommendations to carry the vision forward.

© 2017 LogiSolve, LLC. All Rights Reserved. Equal Opportunity Employer | Privacy Policy | Contact
LogiSolve, LLC. | 600 Inwood Ave N | Suite #275 | Oakdale, MN 55128 | Tel: 763.383.1000 | Fax: 651.207.5067 | info@logisolve.com