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One of the nation’s largest federal health agencies engaged Tenasol to transform its Health IT program and expand access to electronic health records following 2 years of declining growth. Tenasol delivered a multi-year solution, leading implementation of a modernized enterprise interoperability platform, enabling access to medical records from over 300,000 healthcare providers, faster claim processing timelines and improved customer experience for millions of beneficiaries.

A health plan customer selected Tenasol to perform Quality NLP to support HEDIS measure rate compliance. Within 48 hours, Tenasol delivered 90% of all identified clinical codes mapped to the corresponding quality measure to support supplemental data submission. This improved the health plans rate compliance and eliminated the need for manual review on most hybrid and electronic clinical data systems (ECDS) measures. This program delivered a 7:1 ROI, with cost savings of 70%.

Poor data quality between two leading federal agencies was impacting timeliness of benefits for our nation’s most vulnerable citizens. Tenasol’s AI-enabled automated data quality solution was chosen for its ability to analyze millions of unstructured documents, from medical records to release forms, alerting agency representatives of errors or quality issues in real-time. Our solution enables accelerated benefits claims, eliminates hundreds of hours of manual effort and improves service for disabled populations and former service members.

Driven by the need to better manage risk adjustment operations for 4 million MA and ACA members, our customer needed a medical record processing solution to extract valuable member and provider data, detect duplicate records, and rank records based on risk adjustment value. The health plan leveraged the Tenasol Hub to process over 1M records, decreased time to review by 90%, and identified 99% of HCCs validated with clinical evidence. To date, the program has delivered a 4:1 ROI.