AWS Case Study: TC3 Health
TC3 Health’s technology validates payment integrity and maximizes cost savings in an industry that sees double digit increases each year and spends $250 billion in healthcare claims overpayments. Founded in Costa Mesa, CA in 2000, TC3 Health Inc. provides integrated healthcare cost containment services to U.S. payers and insurance providers.
TC3 is growing very rapidly with an average annual increase of over 40% for the last four years. “Growing at this rate year over year requires continuous management of and investment in processing capacity and utilities, including power and cooling,” recalls Paul Horvath, Chief Technical Officer, TC3 Health, Inc.
Using traditional servers and suffering from occasional sub-par system performance, TC3 Health started looking at alternatives to manage their growth. “After looking at products from multiple vendors, we chose Amazon Web Services (AWS) because we felt that AWS provided a comprehensive set of building blocks giving TC3 the flexibility to build systems in a way that was most applicable to our business. AWS has all the pieces we need at a price point well below the competition.”
“We are utilizing Amazon S3, EC2, and SQS to enable our claim processing system capacity to increase and decrease as required to satisfy our service level agreements (SLAs). There are times we require massive amounts of computing resources that far exceed our system capacities and when these situations occurred in the past our natural reaction was to call our hardware vendor for a quote. Now, by using AWS products, we can dramatically reduce our processing time from weeks or months down to days or hours and pay less than purchasing, housing and maintaining the servers ourselves,” says Horvath. In fact, TC3 health has recently begun providing retrospective claim processing services which is essentially processing multiple years’ worth of data at a time; this wouldn’t have been possible with a traditional architecture model.
As a company with access to sensitive patient records and healthcare claims, TC3 is required to comply with the U.S. Department of Health and Human Service’s Health Insurance Portability and Accountability Act (HIPAA) regulations. HIPAA requires companies like TC3 Health to establish certain security and privacy standards for electronically transmitting health data.
Using AWS, TC3 had to make some modifications to their architecture to ensure it was protected while being transmitted in the cloud. “Reduction/elimination of protected health information (PHI) in the data processed using AWS was the main modification we made to the architecture. As an extension of our system, we simply encrypt and send the data we need processed to the AWS cloud while the majority of the PHI is retained in-house and is reconnected with the processed data upon its return,” says Horvath. TC3 retained the services of Milliman USA to establish its HIPAA compliance standards and documentation.
Using AWS, TC3 Health was able to produce a HIPAA-compliant application that scales as they do. Horvath continues, “AWS is a great fit for us because it allows us to economically expand and contract our computing resources to match the ebb and flow of our claim volume without making any long-term financial commitments or capital expenditures. Plus, the people at Amazon Web Services are terrific to work with. We feel that they are dedicated to helping us succeed and it’s obvious that they are committed to the products as seen by improved performance, increased stability and lower pricing.”
TC3 (Total Claims Capture & Control) Health delivers a range of healthcare cost containment and data analytics services, including billing healthcare fraud detection, out of network claims management, pricing, auditing and reimbursement tools, predictive modeling tools, data analytics, and web-enabled reporting. In addition to these sophisticated technology offerings, TC3 also has trained case investigators, trainers, and other staff on hand to deliver a comprehensive healthcare fraud detection and protection solution. With these tools, TC3 is able to help their clients reduce paid claims by 3-10% annually.
To learn more about TC3 Health, go to http://www.tc3health.com
.
©2011, Amazon Web Services LLC or its affiliates. All rights reserved.
