GxTrace™

Medical & Pharmacy Benefits Request Management Solution

Today’s regulatory compliance needs are becoming more complex and challenging each day. GxTrace™ enables compliance and accuracy, ensuring authentic detail for audits through end-to-end traceability. Our automated approach provides the detail required for compliance with any guideline, standard or regulation, delivering a 50% reduction in compliance-related costs.

Previous compliance models were labor and cost intensive requiring highly specialized subject matter expertise; however, human error meant significant challenges in terms of reliability. In addition, compliance activities base finding on post-facto audits and not real-time information. This represents a significant opportunity cost for companies. GxTrace™ moves the subject matter expertise to a systemic level. Our approach to compliance increases your speed to market, provides authentic detail and delivers 100% end-to-end audit ready traceability.

100%

End-to-end audit ready traceability

50%

Reduction in compliance related costs

100%

Coverage on tracking and alerting on SLAs

Globally Implemented at Fortune 20 Organizations

Productized Service for
  • Reviewing and defining control points for regulatory guidelines and client demands
  • Defining and implementing automated control points, monitoring, and alerts framework based on thresholds
  • Defining and implementing reconciliation framework and automation to meet statutory requirements
  • Audit friendly framework
  • Regulatory data stores for compliance needs
  • Audit universe for adhoc and regulatory investigation
  • Reconciliation of all the mandatory mappings for compliance
  • End2End traceability of system of record entries
  • Audit and compensating controls for all system hand-offs
  • Identify source systems with data transition
  • Build out control point mapping
  • Trace failure points
  • Identifying destination transitions for mapping
  • Build unique mapping for each system transition (hop)
  • Build compensation controls, if auditable control points are not available
  • Reconcile source system data with expected destination and report dropouts
  • Establish pattern analysis for exception processing
  • AS-IS and gap analysis
  • System flow and data flow schematic
  • Pattern analysis
  • Drop out reports
  • Timeliness control/aging analysis
  • Root cause and rule identification
  • Data sources
  • E2E framework
  • Data validation
  • Control development
  • GxTrace™ execution
  • Report distribution
  • Fallout Analysis
  • Remediation planning
  • System enhancements