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Smart.Audit.ADT IQ

Smart.Audit.ADT IQ is a managed service designed to streamline the medical audit process for health insurance plans and medical auditors. By leveraging Amazon Intelligent Document Processing (IDP) and related serverless AWS products, Smart.Audit.ADT IQ enables efficient capture, classification, extraction, enrichment, review, and validation of critical information from paper-based records submitted by hospitals and clinics. This service simplifies compliance with the AWS Well-Architected Framework, ensuring a secure, reliable, and cost-effective solution.

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By leveraging AWS's cutting-edge technologies, including Amazon IDP and serverless architecture, Smart.Audit.ADT IQ streamlines the capture, classification, extraction, enrichment, review, and validation of critical information from paper-based records submitted by hospitals and clinics.

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What we offer ?

Smart.Audit.ADT IQ is a managed service that automates and optimizes the medical audit process for paper-based records.

For Who ?

The service is designed for health insurance plans and medical auditors who need to efficiently process and validate information from hospital and clinic records.

Smart.Audit.ADT IQ utilizes Amazon IDP and related serverless AWS products to capture, classify, extract, enrich, review, and validate data from paper-based records, ensuring compliance with the AWS Well-Architected Framework.

How do we Leverage AWS ?

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Financial Benefits

  • Reduced labor costs through automation

  • Eliminated infrastructure costs with serverless architecture

  • Scalable cost structure based on usage

  • Minimized IT overhead as a managed service

  • Increased productivity and revenue potential

  • Reduced error-related costs

  • Cost avoidance through compliance

  • Long-term cost savings from process optimizations

Operational Benefits

  • Streamlined and automated workflow

  • Reduced manual effort

  • Improved data accuracy

  • Enhanced compliance with regulations and policies

  • Scalability and flexibility through serverless architecture

  • Faster turnaround times for audits

  • Enhanced collaboration among team members

  • Continuous improvement driven by data insights

Benefits of the Cloud Adoption Framework

By aligning with the AWS Cloud Adoption Framework, Smart.Audit.ADT IQ delivers a comprehensive set of benefits across multiple perspectives, enabling health plans to transform their medical audit  operations and achieve their business objectives more effectively.

Business Perspective

  • Alignment with business goals: Smart.Audit.ADT IQ supports the organization's objectives by improving the efficiency and accuracy of medical audits, contributing to better decision-making and financial performance.

  • Agility and innovation: The service's integration with AWS cloud services enables rapid implementation, scaling, and adaptation to changing business needs, fostering innovation in the medical audit process.

  • Improved customer experience: By streamlining the audit process and reducing errors, Smart.Audit.ADT IQ helps deliver faster and more accurate results to customers, enhancing their overall experience and satisfaction.

People Perspective

  • Employees to focus on higher-value activities that require human judgment and expertise, leading to increased job satisfaction and productivity.

  • Skill development: The adoption of intelligent document processing technologies and AWS cloud services encourages employees to acquire new skills and knowledge, fostering a culture of continuous learning and growth.

  • Collaborative environment: The centralized platform facilitates collaboration and knowledge sharing among team members, improving communication and driving collective success

Governance Perspective

  • Improved risk management: Smart.Audit.ADT IQ's adherence to the AWS Well-Architected Framework ensures that the service meets high standards of security, reliability, and compliance, mitigating risks associated with data privacy and regulatory requirements.

  • Standardized processes: The service promotes the standardization of medical audit processes across the organization, ensuring consistency and facilitating governance and oversight.

  • Audit trail and accountability: The integration with AWS services enables detailed logging and monitoring of activities, providing a clear audit trail and promoting accountability throughout the medical audit process.

Platform Perspective

  • Robust and secure infrastructure: Smart.Audit.ADT IQ leverages AWS's highly secure and reliable cloud infrastructure, ensuring the confidentiality, integrity, and availability of sensitive data processed during medical audits.

  • Scalability and elasticity: The serverless architecture allows the service to automatically scale resources based on demand, accommodating peak workloads without the need for manual intervention.

  • Integration and interoperability: The service's integration with various AWS services enables seamless data flow and interoperability with existing systems and tools, enhancing the overall efficiency of the medical audit process.

Security Perspective

  • Data protection: Smart.Audit.ADT IQ inherits AWS's comprehensive security measures, including encryption, access controls, and network security, protecting sensitive data throughout the audit process.

  • Compliance and regulatory alignment: The service's adherence to the AWS Well-Architected Framework ensures compliance with industry-specific regulations and standards, such as HIPAA, reducing the risk of non-compliance and associated penalties.

  • Incident response and business continuity: The integration with AWS services enables robust incident response and business continuity mechanisms, minimizing the impact of potential security breaches or disruptions.

Operation Perspective

  • Simplified operations: As a managed service, Smart.Audit.ADT IQ reduces the operational burden on the organization by automating key tasks and leveraging serverless architecture, minimizing the need for infrastructure management and maintenance.

  • Monitoring and visibility: Integration with AWS monitoring and logging services provides real-time visibility into the performance and health of the service, enabling proactive issue detection and resolution.

  • Continuous improvement: The service's integration with AWS services facilitates the collection and analysis of operational data, enabling data-driven optimizations and continuous improvement of the medical audit process.

Leveraging AWS Well-Architected Framework

By leveraging these AWS products and services, Smart.Audit.ADT IQ can build a robust, secure, and cost-effective serverless architecture that aligns with the best practices of the AWS Well-Architected Framework. This ensures that the solution is optimized for operational excellence, security, reliability, performance efficiency, and cost optimization, delivering maximum value to healthcare organizations.

AWS products that can be integrated into Smart.Aduit.ADT IQ, a healthcare solution for managing the medical audit process, including capturing, classifying, extracting, and enriching data from medical records. These products enhance Smart.Audit.ADT IQ's capabilities in extracting insights and understanding unstructured healthcare data:

  • Amazon Textract: Extracts text, handwriting, and structured data from scanned claim forms, enabling accurate data capture and reducing manual data entry.

  • Amazon Comprehend Medical: Extracts insights and relationships from unstructured medical text within claim forms using natural language processing (NLP) and machine learning. This helps in understanding the context and identifying key information required to perform a medical audit.

  • Amazon Rekognition: Analyzes and extracts information from medical images or supporting documents attached to the claim forms, such as itemized bills or medical records.

  • Amazon Transcribe Medical: Converts speech-to-text for any audio recordings associated with the claims process, such as voice notes from healthcare providers or recorded calls with insurance representatives.

The Core

Operational Excellence Pillar

  • AWS Lambda: Serverless compute service for running code without provisioning or managing servers. It allows the execution of data processing tasks, such as document classification, extraction, and enrichment, in a scalable and efficient manner.

  • Amazon CloudWatch: Monitoring and observability service for AWS resources and applications. It provides real-time visibility into the performance and health of the Smart.Audit.ADT IQ service, enabling proactive issue detection and resolution.

  • AWS Step Functions: Serverless orchestration service for coordinating multiple AWS services into serverless workflows. It allows the creation of complex workflows for the medical audit process, ensuring proper sequencing and error handling.

  • Amazon EventBridge: Serverless event bus for building event-driven architectures. It enables the triggering of Lambda functions based on specific events, such as the arrival of new documents or the completion of processing tasks.

  • AWS Identity and Access Management (IAM): Service for securely managing access to AWS resources. It allows the creation of granular permissions and roles to ensure that only authorized users and services can access the Smart.Audit.ADT IQ components and data.

  • Amazon Cognito: Fully managed user identity and access management service. It enables secure user authentication and authorization for the Smart.Audit.ADT IQ application, ensuring that only authenticated users can access the service.

  • AWS Key Management Service (KMS): Managed service for creating and controlling encryption keys. It allows the encryption of sensitive data processed by Smart.Audit.ADT IQ, both at rest and in transit, ensuring data confidentiality.

  • AWS CloudTrail: Service for governance, compliance, and auditing of

  • AWS accounts. It enables logging and monitoring of API activity within the Smart.Audit.ADT IQ service, providing a clear audit trail for security and compliance purposes.

Security Pillar

Reliability Pillar

  • Amazon S3: Highly durable and scalable object storage service. It serves as the primary storage for the documents processed by Smart.Audit.ADT IQ, ensuring data durability and availability.

  • AWS Lambda: Serverless compute service for reliable execution of data processing tasks. It provides automatic scaling and high availability for the Smart.Audit.ADT IQ processing components, ensuring reliable operation even during peak workloads.

  • Amazon DynamoDB: Serverless NoSQL database service for storing metadata and processing state. It provides a highly available and scalable storage solution for the Smart.Audit.ADT IQ service, ensuring reliable operation and data persistence.

  • AWS CloudFormation: Infrastructure as code service for provisioning and managing AWS resources. It enables the creation of standardized and reproducible infrastructure templates for the Smart.Audit.ADT IQ service, ensuring consistent and reliable deployment across environments.

  • Amazon Textract: Fully managed OCR service for extracting text and data from scanned documents. It provides high-performance and accurate text extraction capabilities for the Smart.Audit.ADT IQ service, enabling efficient document processing.

  • Amazon Comprehend Medical: Natural Language Processing (NLP) service for extracting insights from unstructured text data. It enables intelligent classification and entity extraction from the processed documents, enhancing the performance efficiency of the Smart.Audit.ADT IQ service.

  • Amazon SQS: Fully managed message queuing service for decoupling and scaling microservices and serverless applications. It enables efficient communication between Smart.Audit.ADT IQ components, allowing for asynchronous processing and improved performance.

Performance Efficiency Pillar

Cost Optimization
Pillar

  • AWS Lambda: Serverless compute service with a pay-per-use pricing model. It allows cost-effective processing of documents by only charging for the actual compute time consumed, eliminating the need for provisioning and managing servers.

  • Amazon S3: Cost-effective object storage service with different storage classes based on data access requirements. It enables the storage of processed documents in the most cost-optimal manner, based on the frequency and urgency of access.

  • Amazon DynamoDB: Serverless NoSQL database service with on-demand capacity and cost-effective pricing. It allows for cost optimization by automatically scaling capacity based on usage and only charging for the actual resources consumed.

  • AWS Cost Explorer: Cost management tool for visualizing, understanding, and managing AWS costs and usage over time. It enables cost monitoring, allocation, and optimization for the Smart.Audit.ADT IQ service, helping to identify cost-saving opportunities and ensure cost efficiency.

  • AWS Lambda: Promotes sustainability by efficiently allocating compute resources and reducing energy consumption.

  • Amazon S3: Stores data in shared, multi-tenant hardware, optimizing resource utilization.

  • Amazon DynamoDB: Provides a serverless database that automatically scales capacity, minimizing over-provisioning and reducing energy waste.

  • AWS Customer Carbon Footprint Tool: Helps measure, track, and reduce the carbon emissions associated with using AWS services.

  • Implement efficient data storage practices, such as using Amazon S3 Intelligent-Tiering, which automatically moves data between access tiers based on usage patterns, optimizing storage costs and reducing the storage footprint.

  • Take advantage of AWS's commitment to renewable energy by running Smart.Claim.ADT IQ on AWS regions that have a higher percentage of renewable energy mix.

Sustainability Pillar

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