Case Studies

The challenge/problem
Each year coaches and assistants comb through thousands of records on a high school athletic reporting system to identify a pool of potential candidates they would like to recruit. This is a time consuming and laborious task that takes away from time that could be better spent actually recruiting.

The solution
We deployed a Robotic Process Automation (RPA) solution. RPA is an advanced form of business process automation where bots (digital robots) mimic tasks performed by a human on their computer with or without human intervention.​ We created an attended bot, which relies on human intervention for some steps, that would allow the assistant coach to quickly and easily search through a nationwide database to find high school students that met the team’s desired qualifications for recruitment.

The impact
By utilizing the bot, the college was able to expand their search for potential athletes from regional to nationwide. Our solution also reduced the time to build the pool of candidates from two months to just a couple of hours. The coaches can now reach out to their pool of athletes that meet their parameters faster than their competitors and focus their energies on a more personal reach to the athletes.

The challenge/problem
The IT administration staff at the club required central monitoring , antivirus management, patch management, and second level support from an established service provider. An independent consultant was leaving gaps in their security, maintenance, and backup posture. Having only one IT person wasn’t working out and they found themselves in a constant break-fix cycle.

The solution
Garnet River was brought in to provide guidance and a solid support infrastructure. After an initial assessment, we worked with the onsite administrator to remove obsolete software, defective hardware, poorly working antivirus, and inadequate backup systems. We then began Co-Managed IT Services where Garnet River remotely manages all patches, backups, antivirus updates, network monitoring and security, office 365, email security and alerting. Co-managed services provides the necessary support to the onsite staff, as well as CTO level guidance on new projects and initiatives.

The impact
Garnet River has worked with the club for over three years, ensuring smooth and reliable IT operations. During a period of no IT staff onsite, we smoothly assumed IT roles and then ensured a clean transition to the new onsite staff. Their onsite IT can now focus on urgent requests and other tasks knowing the systems and security of the organization are well cared for by Garnet River.

The challenge/problem
With leadership and staff changes happening simultaneously, the organization contacted Garnet River for their IT services expertise.

The solution
During the organization’s transition period we performed a complete IT and HIPAA audit, assumed control of all IT systems, transitioned away from the IT Director, assisted with the hiring process of the new IT staff, and implemented our Co-managed IT solution in their organization. Garnet River performs all day-to-day tasks of monitoring backup, antivirus, mail security, office 365, mobile device management, remote worker VPN support, and management reporting. We provide second level support to the onsite IT staff, as well as scheduled calls with the client to provide CTO level guidance on new projects and initiatives.

The impact
Our client has enjoyed smooth IT operations for over two years while engaged with Garnet River. Their onsite IT staff can focus on urgent requests and other tasks knowing the systems and security aspects of the organization are well cared for by Garnet River.

The challenge/problem
Time-consuming, redundant tasks were taking up precious time of valuable employees.

The solution
We deployed a Robotic Process Automation (RPA) solution. RPA is an advanced form of business process automation where bots (digital robots) mimic tasks performed by a human on their computer with or without human intervention.​ We created an attended bot, which relies on human intervention for some steps, that would gather the necessary information and format it into a standard template to distribute two weekly compliance reports to senior executives.

The impact
By utilizing the bot, HR employees have four additional hours per week to spend on more value-adding and complex tasks while the bot automatically creates the compliance reports.

The challenge/problem
In order to retain their Federal funding, Departments of State need to ensure that their systems and procedures comply with Federal, State and Local Quality Assurance mandates. The client needs a service provider with deep experience in Medicare and Medicaid.

The solution
Garnet River’s team, with decades of experience in healthcare mandates and operational management, works with the Department of Health to identify necessary system changes, prioritize development and deployment order with their technology vendors, and ensure that the vendors test sufficiently. In addition, the Garnet River team identifies system problems that have financial impact, such as Medicaid paying for ineligible claims and not paying for eligible claims. Garnet River is also an overall efficiency and process improvement partner and helps identify other areas of cost reduction, operational efficiencies, and staff satisfaction leading to higher retention.

The impact
Garner River’s client continues to keep its federal funding, has continued to drive cost reductions and driven a higher retention of Medicare providers.

The challenge/problem
In 2018, approximately 30% of DDI projects exceeded the approved budget of allocated DDI hours by allowing frequent changes to the projects’ scope and requirements, as well as inconsistently monitoring IMS tasks and timelines.

The solution
Garnet River created a database and reporting tools which allowed DOH to closely monitor DDI works project progression in accordance to the Basis of Estimations (BOEs) and IMS project schedule by implementing the following:

• Change Advisory Board (CAB) was developed to approve any changes to scope and/or requirements that will impact the approved allocated hours and budget for each project.
• Weekly hours burn rate reporting was created to monitor Vendor hours worked on a weekly basis to ensure hours are in alignment with approve BOE per SDLC phases.
• IMS plan changes were made to track resource hours per project plan task to identify timeline delays more quickly and resolve issues and risks more efficiently.
• Over 50 queries were developed to analyze Supplemental Invoice data per project by resource hours and costs in comparison to IMS project tasks and resources to ensure billing is in alignment with approved BOE and IMS schedule.
• Budget Tracker was developed to continuously monitor the Fiscal and Contract year approved budgets to ensure DOH had the ability to work on “unplanned” Release work while staying within budget constraints.

The impact
Less than 5% of DDI projects exceeded their approved hours and budget in 2020. The projects that did exceed approved hours had received prior approval via the CAB.

The challenge/problem
CMS Audit identified several Corrective Action Plans (CAPs) and the carrier saw a decrease in CMS Star ratings around Member Complaints and Health Plan Performance, Health Plan Customer Service, Drug Plan Customer Service and Member Complaints and Drug Plan Performance.

The solution
Garnet River developed a Regulatory Matrix for each functional area and performed an analysis to identify the functional area processes where the carrier was not in compliance with defined CMS Standards and Regulations. Approx. 75 findings were identified with proposed solutions. For example:

• Modifications to be made to the systems Customer Service Workflow and Benefit Configuration to automate Appeals and Grievances process steps and streamline Cross Functional Area Communications.
• Developed Oversight tools to better manage RX Vendor processes, modified outbound file layout to decrease processing error ratios, and identified additional Service Level Agreements to hold RX Vendor more accountable.
• Implementation of an ongoing Quality Assurance Program in accordance to CMS Standards and Regulations for all Functional Areas.

The impact
All CAPs were mitigated and approved by CMS and the plans CMS Star Rating has increased by 1 point in most categories allowing them to have an overall Star Rating of 4.5.