Every payment processed by a 1,500 bed Connecticut-based hospital involves a number of file transfers. This translates to thousands of file transfers that their IT team needs to handle on a daily basis.
To start a payment process, the hospital submits an 837 Health Care Claim form to an insurance company or similar entity. This form is sent to a clearinghouse to be “scrubbed” before it is sent on to the payer. Each file contains personal health information (PHI) and other sensitive information like social security numbers. And they all need to be protected to meet HIPAA compliance and avoid a data breach.
In response to a submitted 837 form, the payer sends back an 835 Health Care Claim Payment and Remittance Advice form to the hospital. This 835 form allows the hospital to track what payments were received for services rendered. The hospital must submit at least one 837 form for each patient that is discharged. In return, they may receive one or more 835 forms from an external party.
Scripting Can’t Keep Up
Many of the insurance companies the hospital works with provide a 48-hour turnaround time in sending payment from when a clean claim form is submitted. As the billing process has a lot of visibility within the organization, IT was on the hook to make sure this process ran smoothly, efficiently, securely and minimized, if not eliminated, any chance for delays in payment for medical services provided to patients.
However, the IT team had been relying upon a set of custom scripts to transfer files which led to the following challenges:
- Scripting was time consuming and expensive to maintain, scale and control
- Scripts were written by different people over time, in difference languages
- It was difficult to guarantee that scripted workflows were HIPAA compliant and no way to tell if a file transfer was successful or not
- Homegrown scripts could introduce the possible risk of data breaches due to unintentional coding mistakes or human error
Automated File Transfers Bring Security and Control
The IT team was given a directive to quickly find and implement a new way to manage file transfers. They selected MOVEit Automation to secure file transfers and make them a lot easier to manage and control. Using MOVEit Automation, the IT team quickly created more than 30 different file transfer tasks to support medical billing.
Workflows are “daisy-chained” so that new tasks automatically start as the prior ones complete. This allows for file transfers to automatically kick off at the appropriate time. This eliminates scheduling gaps and ensures the entire process runs as quickly and smoothly as possible.
Using MOVEit Automation, it took IT only one week to create and test all their file transfers that support medical billing related tasks. MOVEit Automation also simplifies the onboarding of new file transfer tasks. For example, if the hospital needs to send files to another vendor, the IT team can easily switch out the hosts in an existing task instead of writing a completely new one. If the changes are more extensive, IT can clone and modify an existing task. This saves time and has made the process of working with new vendors quick and seamless.
MOVEit Automation also issues real-time alerts on file transfer failures, allowing the team to quickly and effectively respond to and resolve any problems that arise.
Most importantly, as the hospital continues to build their network of vendors and partners, they feel confident that MOVEit will provide them with the flexibility to quickly onboard new file transfers and related tasks. All this while ensuring that 837/835 forms are submitted and processed in a timely fashion.
If you'd like to see how MOVEit Automation can help save you from scripting nightmares, tune into one of our twice weekly live demonstrations.