Summary: CommunityCare of Oklahoma (CCOK) faced challenges with its outdated adjudication platform and enterprise databases. Partnering with SourcEdge, they modernized systems by migrating to the cloud and updating their core platform. Results:
CommunityCare of Oklahoma: Modernization Improves Claims System Lifetime and Performance Read More »
Summary: A U.S. health plan aimed to rapidly expand its product lines into the Affordable Care Act and Medicaid sectors across multiple states. Facing the challenge of converting their legacy system to TriZetto’s Facets platform without the necessary expertise or processes, they enlisted SourcEdge’s help to navigate the expansion. Results:
U.S. Health Plan Rapidly Expands in Affordable Care Act and Medicaid Using Facets Read More »
Summary: In response to the No Surprises Act, a regional health plan aimed to offer its members more than the required basic cost-sharing information. They sought to develop a comprehensive price transparency tool that would include all possible charges associated with medical procedures, providing members with accurate and meaningful cost estimates. Results:
Regional Health Plan Going Beyond the No Surprises Act for Price Transparency Read More »
Summary: Dan Kinser, VP of Core Systems at Capital District Physicians’ Health Plan (CDPHP) joined SourcEdge to emphasize the importance of protecting Protected Health Information (PHI) throughout the Software Development Lifecycle (SDLC) in a presentation at the 2023 Cognizant Health Sciences Conference. The focus was on implementing de-identification techniques to ensure patient privacy and maintain
CDPHP: Masks PHI Using De‑Identification Throughout the Software Development Lifecycle Read More »
Summary: Faced with the challenge of transitioning their claims processing system in-house by a non-negotiable deadline, a prominent Florida health plan with over 80,000 members turned to SourcEdge for their expertise in AMISYS Advance. The project demanded rapid adaptation and expert execution to overcome significant operational and staffing hurdles. Results:
Health Plan Taps AMISYS Advance Expertise to Meet Deadlines and Unique Challenges Read More »
