A U.S.-based multi-specialty healthcare provider Ambsi faced operational inefficiencies due to a legacy billing system that led to high claim denial rates, delayed reimbursements, and HIPAA compliance risks. Bravado Solutions was engaged to design and implement a secure, scalable, HIPAA-compliant billing and revenue cycle management (RCM) platform.
The solution aimed to enhance HIPAA compliance, improve claim accuracy, automate revenue workflows, and secure patient data. Key challenges included fragmented patient data across systems, manual billing errors, outdated security protocols, and non-compliance with modern HIPAA standards.
Bravado Solutions implemented a cloud-native microservices architecture hosted on AWS, with core services including claims processing, patient management, payment reconciliation, reporting, and automated notifications. Microservices were containerized using Docker and managed via Kubernetes for elastic scalability. RabbitMQ handled asynchronous communication, and AWS API Gateway ensured secure, unified access.
Integration with EHR systems through secure APIs eliminated manual data entry and ensured real-time synchronization. A robust HIPAA compliance framework included encryption at rest/in transit, JWT-based authentication, RBAC, AWS CloudWatch monitoring, automated security testing via CI/CD pipelines, and regular vulnerability assessments.
Real-time dashboards provided visibility into KPIs such as denial rates and reimbursement timelines. PHI was stored in secure, segmented databases under strict access controls, with automated backups and disaster recovery measures in place.
As a result,
- Client achieved a 35% reduction in claim denials and 30% faster reimbursement cycles.
- Operational efficiency improved with a 25% reduction in administrative time,
- Full HIPPA Compliance and enhanced patient expeirence and trust