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"Fewer than half of all respondents say that their organization has established security baselines for external partners, customers, suppliers, and vendors (43%) or requires third parties to comply with internal privacy policies (37%)."

- PWC Global State of Information Security Study



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Healthcare Plans

Compliance has become increasingly more complicated with the introduction of new guidance, regulations, and standards affecting healthcare plans.  Managing programs that ensure compliance obligations is complex, difficult and costly, particularly if manual approaches must be used. Enterprise GRC platforms are no longer viable solutions because of the time and cost needed to customize.  Avior provides automated solutions tailored to the workflows and compliance content specific to the healthcare sector and its new mandates.

Health insurance companies have seen the regulartory enviornment grow in scope and complexity since HIPAA was passed in 1996.  New mandates covering everything from privacy to financial reporting have made the compliance process more complex and challenging.  Each new regulation forces companies to revamp their existing processes.  First, there is the initial compliance program which is often a massive effort.  This is followed by an integration into existing compliance programs.  Most recently, the new mandates for ICD-10 mean new programs must be scoped, funded and staffed as deadlines loom.  The need to assess the readiness of trading partners, as well as your own internal groups, makes this a significant effort.

The Automation Challenge
If your company has automated compliance systems, most were never designed for ICD-10 programs.  In order to expand these systems, insurance companies must make a capital investment and an even greater expenditure to customize these systems.  Cost is hardly the only issue.  The time required to make a system operational significantly reduces the time to do the actual work to ensure compliance.  Some organizations prefer to use more staff with tools like spreadsheets, simply to get started.  However, this approach is labor intensive and error-prone, resulting in greater risk and significant cost.

The Program Solution
Avior has the solution – literally.  We  developed the ICD-10 Solution Pack to meet these new needs of insurance companies.  First, the Solution Pack is ready to go with all of the components needed to run a successful ICD-10 compliance program.  Everything from work-flow management, to assessments, to audit capabilities are standard.  The Solution Pack has all of the necessary reports and dashboards to ensure effective management and oversight of the program.  Second, the Solution Pack uses Avior's Benchmark on-demand platform.  This Software-as-a-Service (SaaS) approach means you get results quickly, saving valuable time.

The on-demand subscription can run for the duration of the compliance program, eliminating the time and capital expense of procuring and customizing software.  Finally, the Solution Pack is built specifically for ICD-10 programs, giving you a cost-effective way to meet your needs.  You only pay for what you need while you need it.