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Delivering Medicare more nimbly

Agility, quality and cost containment are among the goals set by Noridian Administrative Services (NAS) to reach its vision of becoming the benchmark by which all Medicare/Medicaid contractors are measured.

NAS is a federal contractor for the Centers for Medicare and Medicaid Services (CMS), serving 5.8 million Medicare beneficiaries and more than 130,000 providers in 14 states. That involves handling 7 million Medicare Part A claims and more than 73 million Part B claims.

To make it more agile, NAS implemented a workflow automation project called Cheetah. The first phase of that project, completed in August, resulted in automation of 20 key business processes in 13 departments in 20 weeks.

"CMS will be totally restructuring its Medicare contracting procedures over the next three years," says Julie Paulson, manager of imaging systems and support at NAS, and one of the team leaders of the workflow initiative. "Agility is critical to our response to the upcoming changes in the Medicare delivery system. We are driving hard to expand and leverage our investments in process automation by the end of this year."

NAS chose the OnBase Enterprise Content Management solution from Hyland Software and is working with OnBase solution provider eDocument Resources and workflow automation consultant Green Square. So far, NAS has designed and deployed more than 50 automated workflow processes.

"This initiative is only the beginning of our commitment to be the competitive benchmark among Medicare contractors," says Kaylin Frappier, NAS VP, Medicare B operations. "Our ongoing commitment to automating our business processes enables a much more nimble, responsive and flexible Medicare delivery system at a much lower cost."

Green Square President Mike Hurley says, "Project Cheetah's expansive workflow implementation flies in the face of the typical department-by-department approach adopted by most companies."

According to those involved in the project, cost savings have already been realized. For example, the Correspondence Unit is said to have saved 400 hours of labor in claims appeals in the first month--an annual cost savings to taxpayers of more than $600,000. Customer service call times have been cut in half, and new employee training is more efficient.

In addition to cutting costs and improving efficiency, the workflow also addresses security and privacy concerns. Thousands of faxed correspondences are handled by a fax server, which distributes them to e-mail accounts where they are swept into OnBase. As a result, private health information-laden documents are not lying around on fax machines, and NAS has a log of everyone who has viewed or printed the fax.

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