Use of Cloud Computing and Virtualization in the Time of Recession

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Cloud IT and Regulatory Compliance in Healthcare Industry

Zero-balance auditor Health Check deploys latest IT-as-a-Service

Thanks for taking the time to talk to us. Please tell us about HealthCheck.

Scott Fuller, CIO – Principal Health Check: Health Check is a medical billing agency based in Mexico Beach, Florida. We’ve been in business since 1996 and a Nerdio ITaaS customer since 2014. Health Check provides billing services to hundreds of U.S. hospitals, and has grown by 600% within the past two years.


What kind of billing services does Health Check offer?

Fuller: Health Check is a zero-balance auditor for health care, meaning we help healthcare providers find accounts that insurance companies have not paid in full. Our goal is a 30-day turnaround on accounts, and this timeframe sets us apart from potential competitors. Additionally, each client may comprise twenty individual hospitals, so new clients must be able to scale very quickly.

How important is data security to Health Check?

Fuller: One of the most important selling points Health Check brings to their clients is security. Specifically, the data must be locked down when not being used, be transmitted securely, and have a reliable authentication process.


As a medical billing agency, we need to store and process large amounts of data. Therefore, security and encryption are a top concern, especially as the HIPAA privacy regulations evolve. As a fairly unique company, Health Check requires highly specialized or custom software to process accounts. With the diverse ecosystem of hospital IT systems, Health Check required a solution that is compatible with all different hospital data management systems. In addition, before implementing Nerdio, Health Check had a few local servers, as well as hosted email.


In addition to these security aspects, Health Check is physically located in Florida – an area that is prone to hurricanes. Due to the ongoing risk of storm damage, an IT solution with redundancy and operations in different geographic locations was highly necessary.

HIPAA laws are constantly evolving. How did Health Check meet industry standards for HIPAA security?

Fuller: Specifically, Health Check needed to implement encryption of data-at-rest, secure and encrypted transmission protocols, and authentication for users. However, maintaining regulatory compliance is not the only aspect of security. In order to grow and attract new and higher-end clients, Health Check wanted to achieve the goal of passing a series of audits to attain “high-trust” certification as a healthcare partner.

What kind of problems does outdated infrastructure cause for Health Check IT operations?

Fuller: With their pre-existing level of technology – managed email and a few local servers – it would be prohibitively expensive to add more. This was not only due to the investment cost for new IT hardware, but also for the IT staff that would be required to operate and maintain it. In order to expand business, more employees would be needed. However, supporting more employees would necessitate more infrastructure and support staff – which would in turn become an endless cycle.

What kind of IT infrastructure was necessary for Health Check to interface with vendors?

Fuller: A modern IT infrastructure was required to grow and take on new clients. Meeting HIPAA standards was a good first step in guiding our approach. The implementation of a disaster recovery plan was also necessary to protect data and maximize uptime, helping the marketability of Health Check’s medical billing services.

Each of Health Check’s clients may have their own hardware and software vendor. Even within software vendors, there could be a number of different customized configurations to meet the needs of individual hospitals and healthcare providers. This means that Health Check needed to be able to maintain or improve compatibility with many different hardware infrastructures and software vendors.

Health Check prioritizes flexibility and remote access needed to track users. How was this prioritized and discussed when deciding upon your IT service?

Fuller: One of Health Check’s primary considerations for staffing is the ability to get to work within a reasonable driving distance. This has proven especially important for IT staff, as they are necessary for keeping the equipment running for the rest of the employees. However, if a solution offered the option for remote work (whether for IT staff or other employees), this would present an excellent value proposition. Such a system would also need the ability to track usage and productivity, in addition to granting access to system resources from remote locations.

How did implementation costs factor into your decision making process?

Fuller: In a cost-comparison between standard hardware infrastructure and virtual cloud-based infrastructure, substantial cost savings and transparency were found through cloud-based IT services.


There are two main disadvantages to hardware infrastructure. The first is capital investment – equipment costs money, and it’s hard to liquidate those assets if needed. The second are the invisible costs associated with configuration and maintenance – which include hiring and training employees to manage the hardware, and miscellaneous costs from electricity to cooling to software packages that’ll optimize performance.

How did Nerdio help Health Check with data processing?

Fuller: Simply put, processing data is inherently easier through a virtual platform like Nerdio. Virtual database servers are easy to expand or duplicate to meet growing demand. With the PCoIP protocol, a smaller volume of data is required to be transmitted, meaning that large files can be processed in the cloud without clogging up a network connection.


Nerdio provides disaster recovery and testing to Health Check. All virtual data between two data centers is duplicated between various geographic locations. That way, a potential disaster at Health Check’s headquarters doesn’t take employees offline. It also means that in the unlikely event one data center is disabled, a second one can be activated to keep the business running. And if that wasn’t sweet enough, Health Check (and their clients) can test the disaster recovery feature at any time.

How has updating to a virtual infrastructure affected Health Check’s business operations?

Fuller: With Nerdio’s virtual infrastructure, provisioning a new user takes a quick update to the contract and about four clicks of a mouse. It uses an innovative, custom-built management portal, which automates most of the tasks of provisioning and maintaining a user account. This is possible through the virtual environment - without any hardware to invest in or configure, the cost to scale upwards is dramatically reduced.


By putting in place leading-edge security protocols, easy scaling, and a golden-image based operating system, Health Check has been able to add employees and processing capacity without getting bogged down by the hidden costs of hardware infrastructure.

How has Nerdio’s interface affect working with vendors?

Fuller: Vendors who want to contract a medical billing agency such as Health Check need to not only be sure that their custom applications and databases are compatible, but that any patient data is secure.

Nerdio’s platform functions exactly the same as a traditional Windows environment, including the server-client relationship, Active Directory, and installing applications. If a vendor requires a specific application to process data, it can be installed as easily through Nerdio as through a traditional Windows interface.

Furthermore, if a virtual private network (VPN) connection is required, it can be tunneled into the data center, taking advantage of the high-end security and intrusion prevention systems. This provides the same functionality as a traditional configuration, but with the added benefit of leading-edge security technology.

How did Nerdio go about meeting industry standards for HIPAA security?

Fuller: Nerdio is housed in data centers that use encryption of data-at-rest. It also uses VMware’s suite of applications - including the Teradici PCoIP protocol, which natively encrypts traffic between the client and the server.

In addition, the only traffic sent is images, mouse clicks, and keystrokes – minimizing the amount of data transmitted, and thus lowering the potential exposure to intrusion. Finally, two-factor authentication is required for login, and no data is cached locally on a device. This means that even if a device is lost or stolen, compromising the account is nearly impossible.

What did Nerdio do to remote access to track users?

Fuller: Nerdio’s platform is built around virtual desktop infrastructure (VDI), which natively allows users to log in from nearly any Internet-connected device. Immediately, and without any further configuration, users are able to log into their work network with full access to files, applications, servers, communications, and other job resources.


A built-in suite of monitoring applications can be used to track employees. This includes enabling, disabling, or tracking the time used for Internet applications, web usage, tool usage, and even metrics such as time-per-task.

Nerdio’s implementation of remote access and employee tracking have allowed Health Check to maximize employee productivity, fine-tune the permissions granted to users, and run data analytics against usage to find the most profitable tasks. This has strategically positioned them to improve the value Health Check delivers to their customers.

How did the ITaaS contribute to implement savings?

Fuller: Health Check was in a perfect position to begin the transition to Nerdio. We had reached the end-of-life for various parts of our IT infrastructure, and were looking for a more cost-effective and scalable solution. Nerdio met these goals with a predictable per-user per-month cost, and built-in infrastructure and support that met Health Check’s needs.


In addition to the technical benefits, Nerdio has provided exceptional help desk and integration support. By creating a full-feature package that’s easy to use, and by exceeding Health Check’s expectations for service, Nerdio and Health Check are able to grow together – as Health Check succeeds and grows, so does Nerdio.


What were the results?

Shortly after implementing Nerdio, Health Check negotiated a contract with a new health company they wanted to bring on board. The company decided to conduct an audit of Health Check’s systems and processes. Nerdio agents took around 100 phone calls during the audit, helping Health Check navigate the process. The vendor was very pleased with the results, and signed a contract – which tripled the amount of business for Health Check.

Health Check is committed to helping their customers achieve the highest recovery rates and high touch customer service through their expert staff and next generation technology. For information about the company, please see

More Stories By Xenia von Wedel

Xenia von Wedel is a Tech blogger and Enterprise Media Consultant in Silicon Valley and Paris, serving clients in a variety of industries worldwide. She is focused on thought leadership content creation and syndication, media outreach and strategy. She mainly writes about Blockchain, Enterprise, B2B solutions, social media and open source software, but throws the occasional oddball into the mix. Tip her if you like her articles: