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Government Healthcare BPO Services Technical Summary

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HP is transforming the traditional industry procurement model to a flexible system that allows government healthcare agencies to purchase these and other BPO components together or separately.

  • Healthcare Administration/Fiscal Agent Services
  • Decision Support Services
  • Fraud and Abuse Detection System
  • Immunization Registry Customization and Support Services

Healthcare Administration/Fiscal Agent Services

Building the future for publicly funded healthcare enrollees requires a strong foundation of experienced and knowledgeable human resources, streamlined business processes and enhanced information technology tools. HP Healthcare Administration/Fiscal Agent Services provide people, processes and Web-based information technology infrastructure to empower you to continuously adapt as healthcare, delivery and administration are transformed.

With our Healthcare Administration/Fiscal Agent Services, you can:

  • Focus on strategic planning and health outcomes, undistracted by routine automated program operations
  • Maximize human resources, through meaningful healthcare information delivered when and where you need it
  • Improve the efficiency, accuracy and timeliness of program management, reducing administrative costs and increasing provider and member satisfaction
  • Actively participate in e-health initiatives enabled by our infrastructure
  • Take advantage of emerging technologies like service oriented architectures and emerging standards for automated business alerts and workflow management
  • Gain access to information unconstrained by artificial boundaries and stovepipes

Decision Support Services

A flexible scalable architecture allows for additions of data sources, users and tools. Healthcare data sources are consolidated into an enterprisewide data warehouse to give the truest possible picture of benefits and associated costs. You have access to a library of proven queries that is complemented by the ability to develop customized reports that meet your state's specific needs.

Measure effectiveness using profiling tools:

  • Identify underusage in managed-care environments
  • Identify overusage in fee-for-service environments

Fraud and Abuse Detection System

A complete system that allows desktop access to information and sophisticated analysis tools that help governments detect, prevent, and recover monies lost to fraud, abuse and waste. The system includes detection, investigation, case management and analysis tools. It has a flexible, scalable architecture that allows for easy integration with other enterprise initiatives and provides immediate access to your database information, giving you the ability to prepare ad-hoc reports in minutes.

Spot aberrant behavior earlier using:

  • Sophisticated data mining
  • Rules-based logic
  • Neural network predictive modeling techniques

Immunization Registry Customization and Support Services

Ensuring that providers having the right information when they are making medical decisions is core to improving long-term healthcare outcomes for publicly funded enrollees. Immunizations and other public health screenings are necessary to help win the war against disease. Healthcare professionals need accurate information to ensure the entire population gets the preventive care they need. To minimize costs and increase the effectiveness of public healthcare management and delivery, providers must use streamlined business processes and leverage technology to work more efficiently.

HP Enterprise Services, powered by the Internet, are designed to help ensure immunization delivery and other screenings according to schedule. We customize an application that brings immunization schedule recommendations to any desktop via an easy-to-use system that addresses the key challenges providers and public health officials face.

HP first performs an analysis and customizes a solution to meet each state’s specific needs. States can opt for support in one or more of these areas:

  • Implementation – Services related to analysis, customization and data migration for initial implementation of a fully functional basic system of components
  • User support/training – Development of materials and strategies to train providers and state staff on the functionalities of the application; help-desk services and qualified trainers for ongoing needs
  • Maintenance – Maintains existing configurable application functionality with changing CDC requirements, ensures system availability during core required hours, ensures appropriate backups and performance tuning is complete
  • Customization – Technical and business resources to incorporate new functionality to the system, including documenting requirements and developing, testing, implementing and updating system and user documents

The HP immunization registry application allows you to bring desktop access to real-time registry information via Internet connectivity. Avoid duplicate records via a sophisticated, real-time editing function to eliminate multiple entries and reduce data entry errors. Reduce administrative costs through a Web-based application that enables instantaneous distribution of application, form and tracking schedule changes to an entire user community. Use population and immunization information exchange to meet the greater public health needs, including responsiveness and preparedness through SNS and CRA requirements, as well as leveraging immunization. This efficiency and ease of use translates into lower administrative costs.

Choose HP

HP Government Healthcare BPO Services can position your agency to move forward as the healthcare industry transforms. Our solutions help organizations undertake true healthcare delivery transformation – greater collaboration and improved decision-making as well as greater quality, efficiency and cost-effectiveness of care.

For more information about what HP Enterprise Services can do for you, submit a business inquiry.