Right System, Done Right
Whether it’s selecting the right system, dealing with the complexities of an implementation, or effectively navigating upgrades, core administration systems are complex and often challenging to manage. Catalyst has decades of experience across all major core claims platforms, including QNXT, Facets, Amisys, HealthRules, Epic Tapestry, and other proprietary systems to ensure core systems are aligned and maximized to support the business of a health plan.
Core Systems End to End
Technology to Drive Outcomes
System Selection
Professional Vendor Consultation and Evaluation
01
Catalyst has extensive knowledge of most major health plan core and ancillary systems and tools and guides plans to products that best suit the needs of the plan. Catalyst will provide unbiased advice for vendor evaluation and the selection of new systems. With Catalyst’s library of business and technical requirements knowledge and our structured methodology, Catalyst helps plans to develop the RFP, identify a short list of qualified vendors, and conduct systems evaluations.
Additionally, Catalyst will:
- Develop Scenarios for Proof of Concept
- Facilitate Software Demonstrations
- Conduct Vendor Due Diligence
- Provide Support during Contract Negotiations
- Create & Execute Plan for Implementation
02
A health plan’s productivity and growth potential are largely dependent on the technology at their disposal. Choosing the right software solution, whether it is a core/claims platform, a clinical management application, or a provider data management system, is a serious investment of time and money. Many software implementation and integration projects run into challenges due to the complexities they present.
Leveraging decades of systems implementation expertise, Catalyst helps plans to “do it right the first time” when implementing, integrating, or optimizing technology.
System Implementation
On Time, On Budget
Platform Upgrades
Saving Time and Money with Proven Methods
03
Upgrades to the core platform are a fact of life for most health plans. In many cases, it is necessary for:
- Compliance with Vendor Contracts
- Delivering Fixes for Bugs/Other Issues
- Increasing Platform Security
- Providing New Functionality
Through Catalyst’s extensive experience with most claims and clinical platforms, Catalyst has developed several services that can make upgrading the system easier and more cost-effective. These services include:
- End to End Upgrade Execution
- Governance Planning
- Project Management
- Automation
- Test Plans & Use Cases
- Feature & Functionality Maximization
- Training & Change Management
- Staff Augmentation
04
Health plans need to ensure their technology is secure, controlled, cost-effective and highly available. Many vendors commit to delivering hosting and infrastructure management services that promise to keep the healthcare plan’s applications optimized, secure, and running smoothly. But what happens when the vendor fails to deliver on that promise, or the vendor becomes too costly?
At Catalyst, we partner with the health plan’s technology team to make the move back to an on-premise or a hybrid solution. Catalyst offers:
- Solution Architecture Guidance with Automated Deployments
- Implementation and Project Management
- Architecting Ancillary Software in all New Environments
- Database Migrations
Platform De-Hosting
Taking Back Control
Core Platform Optimization
Enhancing Integration and Interfaces
05
IT departments in today’s health plan are forced to do more with less. Maintaining a sophisticated IT environment with multiple platforms and points of integration is costly. In addition, compliance with government regulations and the delivery of new products and technologies further strain already tight budgets. Therefore, it is crucial that the plan’s core system perform at optimal efficiency.
Catalyst is a leader in providing core platform consulting services to health plans and will maximize the performance of the core platform via:
- Business Rule Design, Configuration & Build
- Custom Code Rationalization & Maintenance
- Business Process Assessment & Workflow
- Configuration Audit & Optimization
- Model Office Test Planning
- Data Conversion & Auditing
- Systems Performance Optimization
- Real-Time Transactions
- Database Migrations (i.e. Sybase to SQL)
- Report Design & Implementation
- Design, Development, Testing, and Implementation of Data Interfaces & Extensions
- EDI Systems Implementation, Data Transformation, Message Flow Management
- Encounter Data Submission and Accuracy Optimization
Client Led Initiatives
Support Services
Catalyst offers several flexible solutions for long and short-term human capital objectives. Whether a health plan needs an interim executive or a team of claims analysts for overflow capacity, Catalyst provides experienced resources with deep health plan expertise who can immediately hit the ground running.
- Interim Health Plan Executives
- Staff Augmentation for Plan Operations & IT Roles
- Flexible support teams for Claims, Configuration, Testing, Development & Customer Service
- Catalyst On-Demand support based upon “bucket of hours”
