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Medical Billing Research · Healthcare

Remedy

A new claims integration with Alberta Health Services that processes claim files in near real time, without disrupting service.

Industry
Healthcare billing
Solution
AHS claims integration
Platforms
Cloud back end, SFTP
Integration monitor showing the SFTP, validate, transform and load pipeline, recent claim files and validation issues

Operational efficiency

Automated claims processing that removes most manual handling.

Compliance

Meets the latest AHS and EPIC standards, keeping the system current.

Security and continuity

Better protection for sensitive data, and an upgrade with no interruption to service.

The challenge

Remedy is a SaaS billing program that lets Alberta medical professionals submit claims to the Alberta Health Care Insurance Plan (AHCIP) through an integration called H-Link.

Major system changes in Alberta, including the introduction of EPIC, meant that integration had to be rebuilt to the latest Alberta Health Services (AHS) standards.

Our solution

We analyzed the new AHS capabilities, then designed and delivered a replacement integration with a clear work plan.

The integration watches an SFTP server for new claim files, processes them in near real time, and extracts, validates, transforms and loads the claims into Remedy’s database.

The result

Remedy moved to the new AHS-mandated integration seamlessly, gaining efficiency, compliance and security with no disruption for its users.

Key features

What we built

SFTP watcher

Monitors the SFTP server so new claim files are processed promptly.

Automated claims processing

Claims extracted, validated and transformed without manual effort.

Validation and logging

Checks and logs that keep data accurate and traceable.

Enhanced security

Stronger protection for sensitive medical and billing data.

Seamless transition

A cut-over to the new integration with no service disruption.

Technologies used

  • React
  • AHS Integration
  • Node
  • AWS
  • My SQL

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