Lack of Consistent & Accurate Medical & Prescription Data

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Challenge: Verification and Prove up of hundreds of thousands of individual opioid claims without any consistent access to medical histories or prescription data.

The opioid crisis affected millions of people but the individuals who suffered addiction and the subsequent problems stemming from addiction led to patients maintaining incomplete and often inaccurate medical records. Compounding the issues were outdated systems of reporting by 3rd party payers and healthcare providers coupled with the compliance rules that allowed records to be purged or destroyed after 5 years. 

Nordstrom and Company worked with medical data analysts and the leaders in healthcare data systems to create a national data exchange that healthcare providers across the country could access. By leveraging our relationships with key data partners, we were able to reach into archival databases through specifically programmed AI that maintained compliance with HIPAA by matching data sets with redacted PII, to maintain patient confidentiality, while uncovering pharmacy and healthcare records that were archived as PDFs. This required not only getting access but also developing a unique character recognition program specifically designed for this specific purpose. 

Once the systems were in place, we were able to go back over 10 years and help qualify claimants in record time but also help thousands of people who would otherwise not have qualified for compensation.