Consulting

ALTEK consultants support a wide range of projects from program and project management, architecture, informatics, full life cycle development, financial auditing analysis and risk assessment. We specialize in developing solutions tailored to an organization’s skill sets, standards, knowledge and existing infrastructure.

The following are some of our consulting projects:

Member Portal

The goal of this project is to enable an online and printable intelligent Health Statement (HS) that would give the policyholder a view of their health plan and funding utilization coupled with general health and wellness information during a determined period of time (monthly, quarterly, annually). It will also include a series of alert messages to notify the subscriber of needed care (e.g. reminders) or purchasing alternatives (e.g. generic drugs).

In July 2009, Health Statements went live to approximately 16,000 subscribers of the 15 largest CDH accounts. The Health Statement is available to subscribers via the HCBO website platform in a Portable Document Format (.pdf). The first release of the Health Statement included the following information:

  • Subscriber Demographics
  • Accumulator Data
  • Medical and Prescription Benefits (English translation)
  • Medical and Prescription Claims Data
  • Health Tips Article

Our responsibilities on this project include:

  • Project Management
  • Solutions Architecture
  • Requirements and analysis
  • Development

Facets Benefit Coding Project

This engagement was a forensic audit of the current benefit configuration comparable to the actual executed contracts and provided detailed analysis on discovered gaps and remediation plans.

IT Informatics Data Warehouse Architecture, Design, Development and Support

This project requires providing and assessing high-level impact of source system changes to the data warehouse and other informatics applications. We assist in developing and implementing innovative solutions to the customers’ problems. We research and analyze customer requirements and apply expert knowledge to determine accuracy and reasonableness of data. We also document and summarize results. Responsibilities also include defining schedules, monitoring systems, tracking system SLRs, and keeping maintenance projects on track for a production system.

Responsibilities include:

  • Technical Lead for multiple projects
  • System Analysis Work
  • ETL Tools (Ab Initio Graphical Development Environment (GDE)
  • Data Profiling (Prefer Ab Initio Data Profiler)
  • Change Control Process
  • Cognos Business Intelligence
  • Healthcare Business Knowledge
  • Metadata job status report, code changes and updates

Legislative Mandate Implementation

We provided a subject matter expert for our client, a large healthcare insurer, as a member of their Legislative Mandate Workgroup. Tasks include documentation, gathering estimates and developing implementation plans for federal and state mandates. Mandates worked on include:

  • HR1 – State Continuation Premium Subsidy (Mini-COBRA)
  • MD Comprehensive Standard Health Benefit Changes – Maryland Small Group Market – increases the age to which dependents may be covered to 25 years and adds coverage for morbid obesity surgery.
  • LabCorp migration from Capitation to FFS – Changes the method for payment to LabCorp for services provided to MD ASO accounts.
  • HB 405 – Mandated Benefits – Breast Cancer Screening – mandates Breast Cancer screening according to the latest American Cancer Society guidelines (does not affect small groups)
  • DC – Insurance Coverage for Emergency Department HIV Testing Amendment Act of 2007 – Provides insurance coverage for Rapid HIV testing in Emergency departments, irrespective of the reason the individual is seeking treatment.
  • COMAR 31.10.11.07e – Referral Matching – disallows the denial of claims for lack of a referral (when a referral is needed) without trying to match on criteria other than referral number.
  • MD HB20 – Intellectual Disability (Rosa’s Law) – replaces mental retardation with intellectual disability in all Maryland state registration.
  • DC Act 17-704 Medical Insurance and Empowerment Act of 2008
  • Medigap Modernization
  • Physicians Rating Systems

Identity and Access Management System (IAM)

Implemented an identity and access management solution for a large healthcare organization. This project required us to work across multiple departments, stakeholders and teams. Our responsibilities included:

  • Project management
  • Development
  • Configuration and administration
  • Testing and quality assurance

Additionally, we built tools to simplify the help desk technicians’ job of assisting users with security and application access.

The project was successful at securing applications across the enterprise.

Contract Management System

Implemented and configured a contract management system at a large healthcare organization. The goals of the project were to provide a single, comprehensive repository for contracts and related documentation, reduce manual and paper based processes, standardize and automate business process and provide improved reporting and decision support.

Our responsibilities were:

  • Project management
  • Configuration
  • Testing and quality assurance

The solution was successfully implemented.

For more information about how ALTEK can help meet your consulting needs please call us at 301.695.4440.