You are here
Whitepapers
The Quantum Choice application from Plexis Healthcare Systems currently uses SQL Server 2005 as its database platform for on-line transaction processing (OLTP) and is in the process of upgrading to SQL Server 2008 for all Public Sector delivery. All other components are built upon the Microsoft .NET Framework. The user-interface is a .NET Framework 3.5 Windows forms application. The processing engines are distributed services for scalability.
Multi-Currency Support, Importing International Code Tables, and Remote Access - This paper examines several key features required for international benefits administration and claims processing, including multi-currency, coding of medical encounters and diagnosis, and remote access issues.
This white paper examines several issues associated with repricing claims. This examination discusses the importance of EDI in solving many of the concerns with repricing, as well as the information system functionality required to maximize repricing efficiency. In addition, it provides a model for optimizing the repricing process by utilizing available technologies.
Extensible Markup Language (XML) and .NET technologies provide the bridge that can link payors, providers and consumers in a new era of healthcare to reduce administrative costs.
Medicare Advantage offers unique challenges to the automated payor market. This white paper examines the basic requirements for processing Medicare Advantage claims, as well as defining and providing guidelines for adjudicating dual eligibility claims.
Brief Overview of History, Regional PPOs, Facts-at-a-Glance - This white paper examines the history of Medicare Advantage, regional Medicare Advantage PPOs, local Medicare Advantage plans, participation and enrollment, benefits and premiums, and Medicare Advantage facts-at-a-glance.
Defining Consumer-driven Healthcare - Healthcare futurists promise that consumer-driven healthcare plans (CDHPs) will enable consumers to make wiser healthcare decisions, reduce administrative headaches, and provide an antidote for runaway healthcare costs. At the same time, it is difficult to find agreement on what a CDHP will look like. Different approaches to consumer-directed healthcare have fostered a wide array of designs that rely on decision support tools and benefit administration processes.
CDHP and Healthcare IT - Part 2 of the the 5-Minute Guide for consumer-driven healthcare examines the IT that will be required to support CDHPs.
