Customer Case Study: Medical Audit & Review

Philadelphia, PA-area based Medical Audit & Review Solutions (MARS) has developed sophisticated analytics and clinically driven processes to identify potentially wasteful or abusive medical bills and resolve them before payment is made.

As a physician led company, MARS has vast experience in medical practice, provider networks and actuarial science, as well as a keen sense of how clinically driven analytics can be employed prospectively to fight medical waste, abuse and fraud.

Because it relies so heavily on analytics, the company requires vast stores of reliable and actionable data that needs to be protected, encrypted, and replicated, as well as easily accessible. So when Gad Hazum joined MARS as Senior Information Technology Enterprise Architect one of the first things he did was recommend Sesame Software and its Relational Junction product suite.

“When I came here in 2012 there was only our cloud CRM, and we had no other tool to get the data,” Hazum explains. “And the data was only at our colocation hosting service provider.”

Realizing that the company needed a comprehensive back-up system for all its data, Hazum immediately thought that Relational Junction would be the ideal solution. “We implemented Relational Junction and its replication capabilities for two reasons,” he says. “The first was to back up the data. We needed regular backups of all of our data from our cloud CRM. And secondly, Relational Junction tools also eased the reporting process.”

MARS relied on Relational Junction to

  • Provide a recoverable data backup.
  • Integrate disparate data repositories for coherent analysis and reporting.
  • Provide cost-effective and straightforward implementation and management.
  • Fit within the MARS operational structure.

Hazum had worked with Sesame Software and used Relational Junction at a previous employer and therefore he was well aware it offered a lot more that data backup tools. So as soon as he could, Hazum also implemented Relational Junction ETL Manager for claims auditing process flow and report generation.

“We began to leverage the ETL part of Relational Junction to allow us to process data in and out of our cloud CRM or as we pushed data from our in-network databases into the Cloud,” he explains, “Relational Junction helped us better take action on the data we had in in the CRM."

The company is upgrading from a SQL Server 2012 to SQL Server 2014, in order to better replicate its data warehouse locally. But Hazum indicates the company will continue to count on Relational Junction as a key tool in its IT infrastructure.

Takeaway

Relational Junction helped us better take action on the data we had. My colleagues at MARS have found Relational Junction to be easy to implement and to work with.” Gad Hazum, Senior Information Technology Enterprise Architect, Medical Audit & Review Solutions (MARS).

“Everything involving Relational Junction has been very good,” Hazum says. “I do have a backup person, the number of times he had to step in in terms of issues with Relational Junction has been so minimal I can’t recall the last time.”