WPC Helps Providence Health Plans Upgrade Technology to Accommodate Future Growth

WPC Helps Providence Health Plans Upgrade Technology to Accommodate Future Growth

Overview

Providence Health Plans is part of Providence Health & Services, a not-for-profit Catholic healthcare ministry committed to providing for the needs of the communities it serves—especially for those who are poor and vulnerable. Providence Health Plans requested WPC review and provide an assessment of its existing BizTalk infrastructure environment which will serve as the basis for its desired future growth and processing of additional healthcare transactions. WPC was an ideal partner for Providence because WPC is a healthcare-focused company with in-depth understanding of the business processes and requirements of the healthcare transactions Providence is currently processing.

Business Challenge

As a result of company growth, Providence was experiencing an increase in transaction volume. Providence primarily started out processing claims and payments (837 and 835), but it wanted to begin processing additional valuable transactions, including enrollment (834) and eligibility look-ups (270 and 271). Microsoft’s BizTalk Server platform was already in place to process incoming claims, but Providence needed help with capacity planning, because it had to grow beyond a single BizTalk Server in order to process a higher capacity of transactions. In addition, Providence was reaching performance constraints in their primary BizTalk application because of the increasing volume of incoming claims and outgoing payments.

WPC Solution

WPC performed a capacity planning overview and benchmarking of Providence’s existing system to evaluate its performance. WPC made recommendations for how Providence could increase its data integration system’s capacity, which included adding an additional BizTalk Server and scaling up its current processing database from one to three, allowing Providence to spread its transactions across multiple databases.

Results

Providence is currently in the process of implementing the recommendations provided by WPC. In addition, Providence has engaged WPC for other initiatives including processing 277CA transactions.



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