Success Story: Healthcare Benefits Organization

Axway Managed File Transfer for Secure eHealth Transactions

  • Headquarters

    United States
  • Industry

  • Challenge

    Migrate healthcare transactions from paper and dedicated private networks to the Internet, while remaining compliant with HIPAA and other regulations

  • Solution

  • Results

    • Rapid return on investment
    • ƒIncreased profit margin by securely moving claims processes online
    • ƒReduced investment in leased lines, proprietary networks and software
    • Reduced business-process cycle time by as much as 75%
    • Eliminated duplicative tasks
    • Provided legal-grade audit trails
    • Compliant with HIPAA regulations regarding privacy and security of sensitive healthcare data

Axway has delivered a compelling, high-ROI solution by providing secure, efficient, Web-based products and services for exchanging data with partners in an auditable manner. The solution leverages the low-cost of the Internet, and is a cornerstone of the organization’s e-Health initiatives.

Axway SecureTransport™ is a cornerstone of this organization’s e-Health initiative. Axway has provided this healthcare insurance company with a high ROI solution for secure, confidential, guaranteed, and auditable data transport solution over the Internet.

Profile

Axway’s client is a large, diversified Healthcare Benefits Organization (HCBO), whose customers include 65% of the Fortune 500 companies. The organization is a leading provider of managed and indemnity health care benefits, and an array of prescription drug, dental, vision, and group insurance plans.

The HCBO’s day-to-day business processes entails the exchange of highly sensitive healthcare data with doctors, hospitals, pharmacies, clearinghouses, plan sponsors, regulatory bodies, auditors, and vendors. These processes include:

  • New Member Enrollment
  • ƒƒPolicy Reviews and Updates
  • ƒƒCompliance Reporting
  • ƒƒPharmacy Rebate Programs
  • ƒƒClaims Overpayment

Like most health insurance companies, this HCBO currently uses paper processes and dedicated leased lines to conduct important claims-related transactions and exchanges. Paper processes are inherently insecure, manual, errorprone, and duplicative. Leased lines, while inherently private and secure, involve high subscription and maintenance costs.

Furthermore, the data transport software and data formats are proprietary. For claims data, the format is usually X.12 EDI; a Value-Added Network (VAN), which charges by volume of data handled, typically routes this. The HCBO realized that it could improve efficiency and cut costs significantly by eliminating leased lines and conducting e-Transactions over the low-cost Internet infrastructure. But how secure is the Internet for exchange of highly sensitive data? What about auditability? In short, is the E-Health strategy consistent with proposed HIPAA security requirements?

The Axway Solution

Axway’s products are scalable, based on an open architecture, and address precisely these security and trust issues in a compelling manner. The Axway solution:

  • ƒƒ Leverages the low-cost Internet architecture
  • ƒƒ Securely transports highly sensitive healthcare data confidentially and reliably
  • ƒƒ Guarantees the integrity of transferred data
  • ƒƒ Generates legally enforceable audit trails for transported data and storage of such data

Axway has delivered a compelling, high-ROI solution to the healthcare organization by providing secure, efficient, Web-based products and services for exchanging data with their partners in an auditable manner. The solution leverages the low-cost of
the Internet, and is a cornerstone of the organization’s e-Health initiatives. Also, the Axway solution addresses the challenges of the proposed HIPAA security regulations for healthcare data.

Axway offers an enterprise-class product for secure, reliable, guaranteed data transfer. SecureTransport can enable the HCBO to initiate, create, store, and access proof of transactions in a legal-grade manner. Not only do Axway solutions increase operating margins by reducing cost, they also demonstrate best practices, and enable organizations to comply with regulations concerning healthcare data.

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