The Assistance Fund (TAF): Improved Patient Reimbursements, Document Parsing, and Customer Relations Management

Organization

Our client, The Assistance Fund (TAF), is an independent nonprofit patient assistance organization that helps patients and families facing high medical out-of-pocket costs by providing financial assistance for their copayments, coinsurance, deductibles, and other medical and health-related expenses. Since 2009, TAF has helped more than 160,000 children and adults obtain access to critical treatment for life-threatening, chronic, and rare diseases. TAF manages nearly 80 disease programs that cover all FDA-approved treatments. They have a GuideStar Platinum Seal of Transparency, a five-star GreatNonprofits rating, and an ImpactMatters-rated nonprofit.

Challenge

AUTOMATED CLAIMS SYSTEM
For TAF, patients’ experience is a top priority. They realized that their legacy claims processing system needed upgrading. Their existing claims reimbursement process was tedious and time-consuming. When TAF recognized that it would be difficult to do this upgrade in-house, they brought in XTIVIA. In partnership, we designed a custom claims process flow to automate eligibility decisions. XTIVIA developed and implemented the solution with MuleSoft, which provides integration for data, applications, and devices on both on-premise and cloud computing environments.

MEDICAL DOCUMENT PARSING
TAF receives thousands of medical documents, and it was very time-consuming for agents to triage, review and map these documents to patients’ accounts – it would typically have taken days. XTIVIA designed and implemented a custom document parsing tool.

SALESFORCE CRM UPGRADE
While developing the claims and parsing tools, XTIVIA learned that TAF’s Salesforce CRM hosting was outdated. XTIVIA upgraded their hosting package from Amazon Web Services (AWS) Classic to Lightning, providing superior usability and additional functionality without needing any code.

BUSINESS RESULT

XTIVIA improved accuracy and faster turnaround of TAF patients’ medical reimbursements by:

• Upgrading and automating TAF’s claims system
• Designing a visual process flow and implementing a custom claims
• Managing the migration, ensuring correct data and object mapping to the new system

XTIVIA improved accuracy and efficiency in TAF’s document parsing and management by:

• Developing a custom document parsing system
• Eliminating a manual triage done by agents which

TAF’s new medical claims system produces reimbursements faster. Agents can answer questions easier and experience more straightforward navigation of the new claims system. This project eliminated manual document triage by agents, improving accuracy and productivity, which has saved valuable resources and time, improved accuracy, and saved cost.

XTIVIA needs the contact information you provide to us to contact you about our products and services. You may unsubscribe from these communications at anytime, read our Privacy Policy here.