Healthcare

Labor intensive workflow issues are the bane of today’s healthcare management—for both the payer and the provider.

General Benefits

With document capture, incoming assets of all kinds, whether paper, images, eforms, or other electronic documents, are converted to electronic images and stored.

The data capture process reads the information contained in these document assets, and the storage in a repository creates a centralized location for all documents—regardless of their origin. Converting paper documents to electronic images allows the images to be backed up to off-site storage that is a lifesaver in the case of a disaster such as floods or fires.

Finding and sharing documents becomes much easier once documents are scanned and indexed with data that allows retrieval of the documents and the generation of useful reports. The scanned images can be used to support online requests for documents, public-facing websites, and more. Additionally, facility space that was previously used to store paper can be repurposed.

Most companies, even those with high volumes of incoming documents, still rely on paper processes.

When working with a client to implement an electronic workflow, InStream first does in-depth analysis of the client’s internal paper processes to find best way to optimize the work. Only then is the flow of the organization’s work converted to electronic document processes. Electronic workflows allow organizations to develop key reports for administrative processes and operations, monitor worker productivity and backlog in real time, outsource administrative processes to become more efficient, and identify trends that help in planning staffing. The number of documents assigned to and processed by each worker can be monitored, reported or reassigned within the company or to an outside resource.

Organizations can expedite the processing of all kinds of correspondence, from HIPAA-compliant paper documents and faxes, to email and other electronic forms.

InStream solutions can convert these documents to electronic images and route them via electronic workflows to designated recipients. The electronic workflows can be used not only to monitor mail turnaround times, backlogs, and user productivity but the electronic routing improves those turnaround times for the organization. Once the mail is processed, it is stored in a secure electronic document management (ECM system) so it can be retrieved for subsequent use or sent to others when needed.  Outsource mailroom services can include core business form processing and data entry to provide additional time and cost savings for clients.

InStream offers a number of secure outsourcing services, with both domestic and offshore options available, beginning at the point of mailroom services and capture.

Once incoming paper forms are converted to electronic images, outsourcing at any level of complexity becomes significantly more efficient and cost-effective. Organizations can outsource enrollment, survey, and prior authorization processing. InStream can offer HIPAA, CMS, and state-agency compliant processing at any document processing stage.

InStream’s service can manage the flow of electronic documents through secure electronic workflows between one or more client facilities, to remote employees, or to the offices of an outsourcing company and back, as though all participants are in the same office. Organizations can choose from domestic or offshore outsourcing. InStream’s outsourcing teams are subject matter specialists, providing knowledgeable additional resources during expanded hours of service, for time-sensitive projects, or seasonal tasks.

With EEOC and FCRA standards, as well as increases in employee litigation, HR departments are facing more scrutiny than ever.

Converting documents to electronic records adds a high level of both accessibility and security. By storing your electronic HR documents in a single repository, historical records are easy to find and reference with the appropriate security controls. InStream solutions empower organizations with multi-site footprints to efficiently and securely manage employment data. Remote locations are empowered to use these tools to deliver data to the home office, reducing the risks of site-stored data getting lost or disconnected from centralized repositories.

Using e-forms and electronic workflows, paper-laden processes like the on-boarding process can easily be converted to electronic forms. With electronic workflows, candidate information can be automatically routed to hiring departments. Care facilities can follow both initial credentialing of physicians and other health care professionals, as well as any related recertification process to maintain current credentialed status. The system can store and track initial hiring forms along with annual reviews, reprimands, and status changes, as well as status of ongoing background checks and routine drug testing. Regulatory, insurance and other compliance information can be retrieved much easier from the indexed form data.

Maintaining document scanning equipment extends the useful life span of the hardware and drastically improves its performance.

Most document scanner maintenance is performed onsite, and these affordable and flexible plans can be customized based on business needs.

Provider Benefits

Medical forms are constantly changing with new compliance and health care regulations.

InStream’s cloud-based Virtual Forms Committee can be used by form management teams to collaborate on updating the design of changing medical forms.  This tool allows committees of doctors and administrators to securely collaborate on form design updates, even when their schedules don’t coincide.

Our solution utilizes abstraction solutions to capture and integrate valuable patient records in hospital mergers, as well as from remote physician groups and facilities.

Active patient records are extracted from patient files in newly acquired or remote physician offices. The extracted data and images can be linked to the client’s central practice manage system to efficiently merge these critical patient records essential for continued care.

As more healthcare plans become high deductible and insurance reimbursement rates decline, an increased number of patients must pay a portion of the healthcare costs.

Providers are faced with processing a much larger number of payments, which is often a time-consuming manual process. InStream can solve this challenge with its outsourced virtual lockbox services.

InStream provides outsourcing services for Explanation of Benefits documents and related correspondence or checks. Processing EOB payments is a complex process requiring capture software that is designed for forms of various lengths and formats. Special technical skills are required to successfully process EOBs and to get the extracted data into the required 835 format for ingestion into the payer’s central practice manage system.

Payer Benefits

InStream builds flexible and customized solutions that combine electronic workflows, outsourcing, and streamlined internal processes for healthcare companies managing seasonal enrollment processing demands.

The company’s expertise is shown in successful outsourcing programs for new member enrollment with some of the nation’s largest Medicare supplement plans. Payers are able to eliminate the daunting task of sourcing and training seasonal staff for open enrollment periods.

Field sales agents fax their new applications documents to InStream. They can then confirm and review submitted orders via secure access into a cloud based solution. This eliminates many calls and uncertainty by the sales staff about the status of their applications. We have created electronic versions of applications that eliminate any data entry needs.

The orders are routed via electronic workflows through the appropriate client processing steps, and then that data flows to the provider’s process management system.

Customer surveys are the most direct way to learn what your company does well—and what you can improve on.

Survey techniques are evolving and new tools are available. Customer demographics and products, as well as business needs, will determine the most suitable survey tools. InStream helps clients process mailed surveys and can build labor saving e-forms for customer to complete.

Prior authorization of healthcare services continues to be a handwritten, fax-reliant process with expedited processing requirements.

InStream has created an outsourced solution that uses modern fax management tools and electronic workflows tools to receive, process, and manage paper, faxed or electronically submitted prior authorization forms in shorter and more reliable time frames. Our solution reduces payers’ cost and the overall complexity of the prior authorization process.

Miscellaneous mailed paper documents require a disproportionate level of time and energy.

InStream successfully outsources all or specific functions of your mailroom to reduce processing times and to electronically deliver miscellaneous documents such as claim appeals, member correspondence, address changes, surveys, etc., directly to intended recipients via predetermined electronic workflows.

Compliance is the thousand pound gorilla in healthcare, and mitigating its risks is paramount.

The Centers for Medicare and Medicaid Services (CMS) in each state’s Department of Health monitor every aspect of healthcare, from turnaround times for preauthorization to enrollment and payment times.  Examples of how electronic documents and workflows can be used to reduce compliance risks include: meeting enrollment time frames, audit support, management of member correspondence, and agent and physician credentialing. InStream solutions not only help healthcare payers do the work in a compliant manner, they can also help payers document that the work is compliant.

Processes that feel natural and intuitive