FS Claim Solutions

Highlights

• Robust security ensures compliance
• Tested DR plan bolsters availability and protects sensitive client data
• Seamless scalability promotes performance and reliability

Quick Facts

• Founded in 2010
• Nation’s largest provider of Medicare reporting services
• Medicare blog named “Best Blog” by WorkersCompensation.com two years running

FS Claim Solutions

FS Claim Solutions is the nation’s leading provider of Medicare secondary payer compliance solutions. Leveraging innovative technology and rich industry expertise, the company provides a comprehensive suite of Medicare reporting services to insurance carriers, third- party administrators and large, self-insured businesses, including Fortune 500 companies. Its services help clients mitigate risk and effectively address the rigid and complex requirements of Medicare compliance to protect the privacy of Medicare beneficiaries’ private information.

CHALLENGE – Escalating data sets and rigorous regulatory demands challenge Medicare compliance business

As the premier provider of Medicare reporting services, FS Claim Solutions is responsible for an exponentially increasing amount of sensitive data, including personal health information (PHI) and personally identifiable information (PII). Its clients—many of which lack the in- house staffing or technology to efficiently and securely manage the highly specialized compliance expectations of Medicare—rely on FS Claim Solutions to report claims and payment information to Medicare on their behalf.

To mitigate exposure for its client and the Medicare beneficiaries they represent, FS Claim Solutions must balance intense regulatory obligations with its ability to transmit large quantities of sensitive data. A lapse in compliance on FS Claim Solutions’s end can compromise protected information and incur staggering fees for its clients and itself.

“We have to make sure our business is scalable and secure,” said Jesse Hamby, vice president of marketing for FS Claim Solutions. “That is paramount above everything else.” Recognizing the expertise needed to deliver a secure, responsive solution, FS Claim Solutions wanted to partner with an IT infrastructure provider that could accommodate fluctuating customer demands without sacrificing performance, security and availability.

SOLUTION – Rapid scalability optimizes performance to securely report beneficiary data

FS Claim Solutions found this IT infrastructure solution with Flexential. Deploying a hybrid IT solution that integrates cloud services, disaster recovery and professional services, FS Claim Solutions is able to address its clients’ most pressing security, compliance and scalability needs.

Specifically designed to meet FS Claim Solutions’s unique requirements, the Flexential cloud enables rapid scalability backed by steadfast compliance. Featuring built-in redundancies, the cloud-based solution provides unwavering uptime to boost productivity. Flexential also undergoes annual audits to maintain its own compliance with industry and regulatory standards such as HIPAA, HITRUST CSF and PCI DSS, and its managed intrusion detection/prevention services offer an additional layer of protection.

To further safeguard data, FS Claim Solutions utilizes the Flexential Recovery Cloud, a disaster-recovery-as-a-service solution that minimizes downtime and data loss. Providing 24/7 support and guided disaster declaration, the Recovery Cloud offers near-real-time replication to bolster FS Claim Solutions’s security posture and recovery capabilities.

To ensure the efficacy of this plan, Flexential helps FS Claim Solutions conduct yearly DR tests. This is a critical differentiator for FS Claim Solutions as its clients want to know that it not only has a DR plan, but that it will work when needed. “This helps us prove we’ve taken the necessary steps to protect data, and our clients, if something were to happen at the headquarters location,” said Dave Bender, chief information officer for FS Claim Solutions.

RESULTS – Seamlessly managing the data tsunami without compromising security or performance

As security requirements and capacity planning continue to headline FS Claim Solutions’s reporting capabilities, Flexential provides the IT backbone to allow the company to proactively keep pace with clients’ rapidly intensifying needs. Over the last couple of years, FS Claim Solutions has seen a sharp uptick in the quantity of data its clients are providing. The Flexential cloud allows FS Claim Solutions to scale in lockstep with this influx of data to optimize performance without impacting security or risking compliance.

These issues have become integral during the sales process as well. “Prospective clients want to know that we can securely manage the transmission of enlarging data sets and meet regulatory requirements,” said Hamby. “It’s a critical part of what we are selling.”

Flexential’s robust security protocols and seamless scalability accommodate fluctuations in reporting needs, allowing FS Claim Solutions to assure prospective clients that it can meet their needs regardless of how large the data set or how demanding the requirements. This ability has been a vital component of its success as the Flexential cloud allows it to ramp up and down quickly—whether to account for new clients, increases in data or the testing of new systems—to continually prove itself as a leader in the Medicare reporting space.

“We need a partner who can handle whatever we throw at them because our business changes very rapidly,” explained Bender. “We need that same kind of quick response and scalability from our vendors.”

FS Claim Solutions’s DR solution also enhances its security posture, promoting business continuity and ensuring critical information is not lost or compromised.

To ensure it remains on the innovative edge of IT capabilities, FS Claim Solutions relies on the Flexential professional services team to augment and support its small internal team—allowing it to remain focused on delivering value to its clients. Flexential expertise and dedication to customer service rounds out FS Claim Solutions’s IT solution by offering a knowledge base it can tap into to discuss existing and evolving needs. This collaboration essentially allows FS Claim Solutions to expand its IT skill set without hiring additional, onsite staff.

“We rely on Flexential heavily because we’re a small IT shop and we know they have the expertise to deliver on our requirements,” said Bender. “Leveraging the expertise at Flexential ensures we’re not behind the eight ball. Flexential is an IT partner for us. They want to make sure we’re successful.”