Our Process and Technical Capabilities

Throughout 20+ years in business and our experience working with 400 clients, Smart Data Solutions has managed and implemented thousands of diverse and complex projects. We have learned which best practices lead to successful projects, and which ineffective and outdated practices put projects at risk. Our time-tested model yields successful implementation results and to us, that means on time, on budget, and aligned with your business goals. Whether you are new to working with Smart Data Solutions or a long-time partner, our development process helps guide you through projects to ensure the best possible position for overall success.

A Stress-Free Process to Automate Your Healthcare Data

Whether you’re new to Smart Data Solutions or a long time partner, our development process helps guide you through projects to ensure the best possible position for overall success.
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STEP #1

Discovery and Understanding

Initial Contact and Solution Scope

Whether your needs are basic or complex, our staff will work with you to understand your needs and the impacts of your workflows.  We believe in focusing on your goals, what you want to accomplish, and from that, identifying the best way to get there.

Discovery and Understanding
STEP #2

Solutions and Best Practices

The Right Tools for the Job

Smart Data Solutions has worked with hundreds of healthcare clients nationwide.  We leverage that experience to provide solutions to best meet your needs.  We know what works, what doesn’t work, and can offer guidance on developing a solution that works for you.

Solutions and Best Practices
STEP #3

Services and Support

Ongoing Direct Customer Support

We believe that the developers who designed and implemented your workflow are in the best position to maintain that workflow.  That is why we continue to provide direct access to our staff to provide ongoing service and support for your account. We take great pride in providing outstanding customer service to meet your current and future needs.

Services and Support
STEP #1

Discovery and Understanding

Initial Contact and Solution Scope

Whether your needs are basic or complex, our staff will work with you to understand your needs and the impacts of your workflows.  We believe in focusing on your goals, what you want to accomplish, and from that, identifying the best way to get there.

STEP #2

Solutions and Best Practices

The Right Tools for the Job

Smart Data Solutions has worked with hundreds of healthcare clients nationwide.  We leverage that experience to provide solutions to best meet your needs.  We know what works, what doesn’t work, and can offer guidance on developing a solution that works for you.

STEP #3

Services and Support

Ongoing Direct Customer Support

We believe that the developers who designed and implemented your workflow are in the best position to maintain that workflow.  That is why we continue to provide direct access to our staff to provide ongoing service and support for your account. We take great pride in providing outstanding customer service to meet your current and future needs.

Machine Learning Integration

While machine learning can be integrated into a number of different processes, the path to integration is similar across the board. Initially using a corpus of known materials, the machine-driven processes record these pilot examples. From there the models use the data to provide suggestions to human processors who make the final determinations. The machines learn from these user selections and over time the processes reach sufficient confidence and accuracy to perform the process themselves, automating certain cases. The final step comes with the machine models taking on the bulk of the work in an automated fashion only allowing the rare edge cases and the routine audit level of documents to post for human review.

Areas where Machine Learning is being used

Mail Processing

Machine learning allows Smart Data Solutions’ mailroom staff to avoid the time-consuming work of manually sorting incoming mail by form and type. This process allows any staffer to quickly prepare and scan inbound mail, leaving the sorting to our automated systems. This automation improves both overall processing time and accuracy.

Correspondence Identification

Different types of correspondence need to be routed to appropriate departments or individuals, and some categories, such as appeals and legal documents, need to be processed with a higher priority than others. Our technology “learns” your correspondence mix, and can quickly and automatically identify the category, priority, and destination of thousands of documents in just minutes.

Data Capture

Normally, data fields captured with low confidence by traditional OCR engines need to be manually reviewed or keyed by a human. With our machine models, we can drive down the number of fields requiring manual intervention, which provides continuous improvement in data capture accuracy and throughput.

Mail Processing

Machine learning allows Smart Data Solutions’ mailroom staff to avoid the time-consuming work of manually sorting incoming mail by form and type. This process allows any staffer to quickly prepare and scan inbound mail, leaving the sorting to our automated systems. This automation improves both overall processing time and accuracy.

Correspondence Identification

Different types of correspondence need to be routed to appropriate departments or individuals, and some categories, such as appeals and legal documents, need to be processed with a higher priority than others. Our technology “learns” your correspondence mix, and can quickly and automatically identify the category, priority, and destination of thousands of documents in just minutes.

Data Capture

Normally, data fields captured with low confidence by traditional OCR engines need to be manually reviewed or keyed by a human. With our machine models, we can drive down the number of fields requiring manual intervention, which provides continuous improvement in data capture accuracy and throughput.

22,000
documents processed per day
200,000
images per day
170+
different models in production
80
hours saved per week for some models

What does the implementation process look like? What can we expect, and how does SDS support it?

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x
  • We will first host a kick-off call to ensure a smooth transfer from sales to development. Your SDS sales rep will fill out an implementation kick-off call outline for you, and that outline will be used during the kick-off meeting
  • It’s a team approach. You’re working with our Implementation Director, a Senior Implementation Manager, and an Account Management Programmer – they drive the implementation
  • Structure is 1 weekly call between our companies to ensure action items are getting accomplished. SDS utilizes project management tool to track action items, risks, timelines, etc.
  • SDS provides implementation checklists, guidelines, best practices, etc.
  • Large amounts of testing.

What is Smart Data’s requirement for customer support in terms of response time and resolution?

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x
SDS’ requirement is same day response time if the request is received before 4:45 pm central Monday through Thursday and 3:00 pm central on Friday. This is fully tracked and audited. Additionally, we offer 24/7 on-shore support which is supported by our development team. You will be talking to an actual developer at Smart Data who can solve the problem fast, not outsourced customer service. If you have an urgent matter, please reach out directly to your support team or the 24/7 SDS Pager
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CLIENT STORY

Brian Janssen

“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development ...”
View Story
icon

CLIENT STORY

Debbie Ziegler

“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs ...”
View Story
icon

CLIENT STORY

Matthew Estes

“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us ...”
View Story

CLIENT TESTIMONY

Brian Janssen

Brian Janssen
VP, System Solutions
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
View Solution

CLIENT TESTIMONY

Debbie Ziegler

Debbie Ziegler
Executive Director of Operations
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
View Solution

CLIENT TESTIMONY

Matthew Estes

Matthew Estes
Chief Information Officer
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
View Solution

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Why handle the heavy lifting of your claims workflow when a smart team enhanced by AI can?

Our tools, solutions, and continued research into new AI and machine learning processes help payers nationwide reduce costs, achieve greater process efficiency, and reduce turnaround times.

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