Clearinghouse for medical claims partners with Omaha tech company

June 6, 2019

She’s a decades-long entrepreneur but a quiet one.

BJ Dvorak studied IT i n the 1970s, when the earliest adopters were getting into computers, and she ended up a business founder in the insurance industry.

Her first company, MDIP Inc., was formed in 1990, when the clearinghouse business was in its infancy. The business helped local and regional payers become electronic, and it evolved into eProvider Solutions in 2005.

From an office at 5024 S. Bur Oak Place, the business serves as a claims clearinghouse, offering an end-to-end solution for both payers and providers, processing health care claims for entities of all sizes nationwide.

“We are focused on providing the best customer support we can,” Dvorak said. “We care about our clients. We care about making sure all claims are paid to the highest reimbursement allowed for the patient. Although the patient isn’t our direct client, the patient is our focus.”

Now, a new relationship will help her evolve the business thanks to artificial intelligence and some powerhouse data warehousing.

eProvider Solutions has partnered with Omaha-based H4 Technology to provide advanced claims data management and analytical services to clients.

The relationship came together through longtime Sioux Falls health care executive Tony Tiefenthaler, who now works with H4 as a strategic account executive.

“I’ve known BJ for over 20 years and have great respect for the work she’s done and the service she provides,” he said. “So when I joined H4 earlier this year, BJ was one of the first people I wanted to talk to, to see if we could establish a partnership.”

Dvorak had been following H4 through mutual health care organization relationships.

“The artificial intelligence they have in their product really speaks to me because I deal with data,” she said. “Data is really the king, and for health care organizations on the payer or provider side, data is what helps get claims paid so all organizations can be whole.”

The artificial intelligence and data management capacity that H4 offers will lead to helping clients with predictive analysis, she added.

“That’s really the key for them, to move forward in finding areas where there’s potentially lost revenue. The predictive analysis is really where we’re focused for our clients.”

Claims data management and analysis has become increasingly important as it directly affects health care organizations’ cash flow, H4 co-founder Craig Christenson said.

“Proactively managing denials, time to pay, payer mix and contractual allowances enables health care organizations to know where they stand today and areas they need to improve for the future.”

The partners have started providing the services on a pilot basis to a couple of clients, and Dvorak said there are more waiting once it’s ready to fully roll out.

She predicts her staff of 15 likely will double by this time next year to handle the demand.

“My staff comes first because if they are taken care of then they will take excellent care of our clients” she said. “I just love what I do and love taking care of people.”

Clearinghouse for medical claims partners with Omaha tech company

A new relationship between a quiet Sioux Falls success story and an Omaha tech company could mean new insight for health care organizations.

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