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  Electronic payment system

Custom Project Name

Electronic payment system

Customer (country)

Insurance service provider

Business Case

Medical practitioners face the everyday routine of filling out reimbursement claims for insurance companies, coding them differently for different insurance payers, sending the claims via courier mail to billing houses and then to payers. That process is time-consuming and expensive. Also, while waiting for the money to come, they don't know what stage their claims are at or whether anyone deals with the problem at all. Finally, there is always a chance that some claims could get lost. A customer needed an electronic payment system that would successfully resolve all of the above shortcomings.

Solution

Novosoft developed the "electronic clearing house" to solve the above problem. The "electronic clearing house" system replaces a paper-based claims process for physician practices with an automated, electronic solution that adjudicates claims, adjusts the coding to the insurance companies' standards, and provides physicians with real-time access to their claims processing. The system provides cost-effective solution, since it significantly decreases the use of relatively expensive human labor. The risk of losing a claim at any stage of the process is minimized.

The system, built on Windows DNA technology, provides outstanding performance, scalability, security, and reliability. It is compliant with HIPPA standards and regulations.

Tools and Technologies

Development tools: Microsoft Visual Studio 6.0 (VB, VSS, InterDev), Crystal Reports
Modeling tools: Visio
Management tools: Microsoft Project, Change Management Database (Novosoft internal Lotus Notes based system)
Database servers: MS SQL Server 2000, Application Server IIS 5.0

Benefits

The system significantly decreases courier and labor costs since the physician's office provides billing and patient information electronically instead of via paper, reduces the bills optimization and claims processing time. Thus, the effectiveness of claim processing increases. More patient claims could be processed in much shorter period of time. As a result, all involved parties benefit from the solution.



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