HighPoint Solutions

Practice Areas

Let’s face it: this is perhaps the most uncomfortable period of time in history for healthcare payer organizations. Prior to healthcare reform passing, payers were coming to grips with recessionary factors that caused declines in membership and associated premiums, increased scrutiny from virtually all stakeholders, and significant mandates to implement, including HIPAA 5010 and ICD-10.

Healthcare payers are turning to HighPoint Solutions to help them adapt in an increasingly challenging era by remaining compliant while improving operational processes through best use of technology.

HighPoint’s payer-focused services fall into the following categories:

Compliance

HIPAA 5010 assessment, planning, and remediation
ICD-10 assessment, planning, and remediation
ICD-10 appliance
Healthcare reform

Claims Cycle Management

Claim payment optimization
Claim cycle improvement
Configuration audits and improvement
Payer value chain

Healthcare Management

Utilization management
Care / clinical management
Population health
Wellness management

Packaged Software Implementation

TriZetto

QNXT implementation
Facets configuration audits
Facets implementation

UM/CM/DM packages
Niche

Collaboration based upon SharePoint deployment (internally and externally)
Master data management leveraging Siperian
Continuous improvement through business process management leveraging Pega Systems
Business intelligence and data warehousing