Hi-Tech Health: Customized Claims Processing Applications

Michael A. Carrara, CEO & Tim Walsh, CIO, Hi-Tech HealthMichael A. Carrara, CEO & Tim Walsh, CIO
In 1990, a small New York based Real Estate company was looking for a system to manage medical and ancillary benefits for its workforce. The company was seeking a turnkey Claims Administration System that could process every claim pertaining to medical, dental, employee wellness, and prescriptions. After a quick market analysis, the firm realized that investing in expensive off-the-shelf software packages was not a feasible option, and so approached Hi-Tech Health—a company offering turnkey member administration and claims administration systems. “We realized early on that there was a direct market for a customized, user friendly, and turnkey claims administration system which could be leased for a reasonable monthly cost rather than purchased outright for a high upfront cost,” elucidates Michael A. Carrara, CEO, Hi-Tech Health.

Hi-Tech Health’s core system, the Series 3000 Claims Administration System, is an application which metamorphosed over 26 years with inputs from different claims processors, data entry clerks, HR personnel, and others who work on the system on a daily basis. Being cloud-based, the Series 3000 Claims Administration System requires no additional equipment investments and users can access it easily. “Implementation is as simple as downloading a web-based program that installs a small applet on the user’s PC or tablet,” extols Carrara. Additionally, the app includes a proprietary Virtual Private Network and offers clients the ability to connect and check for available updates to the Connection Software to automatically download and install them.

As Hi-Tech Health develops custom software applications, it is also known for offering its products to clients either independently or by marketing them as one turnkey system.

One of the biggest advantages that we offer all of our clients is our ability to partner and integrate our system with any vendor

For example, the firm has several clients who want only the Consolidated Billing Module and when the payment comes in as one check to these customers, the system allows them to disburse the money to individual vendors.

Elaborating further on the core differentiating factors, Carrara adds, “One of the biggest advantages that we offer all of our clients is our ability to partner and integrate our system with any vendor and also manipulate, transmit, and receive data. We start with building our knowledge of the client’s current workflows and then map their current process to identify areas for improvement.”

In one instance, a third party administrator using Hi-Tech Health’s Series 3000 Claims Administration System was asked to participate in a Request for Proposal (RFP) to provide benefits administration to the retired airline pilots of a major defunct airline. The RFP was submitted at the last moment and was to be awarded to the company that could not only save the association money, but also begin processing claims immediately while cleaning up the massive backlog that had accumulated from the previous carrier. “Our client was up against a major insurer whose proposal included a charge of almost $5 million to build and implement a health benefits plan,” states Carrara. With Hi-Tech Health’s assistance, the client was awarded the contract and was able to design and execute the plan within a month. “The claim backlog was completely caught up within three months and they were able to achieve this for 1/5th of what the Insurer wanted to charge,” adds Carrara.

Down the road, Hi-Tech Health is looking to partner with different predictive analytics and modeling organizations as well as Referenced Based Pricing (RBP) companies. “We already have data warehousing services, so adding the analytics platform to our suite of services will help our clients improve the quality, increase efficiency, and lower the costs of claims payments,” concludes Carrara.