Applications Services for Payers and Health Insurers
Among the Dell Perot Systems® applications solutions for healthcare payer organizations are these key service offerings:
Claims processing systems support
For healthcare payer organizations operating mission-critical legacy applications, continuous support with enhancements and bug-fixing is imperative. Dell Perot Systems provides ongoing system maintenance, enhancement, testing, and interface development work for a variety of existing claims processing systems to ensure uninterrupted system uptime and enhances customer satisfaction.
Dell Perot Systems Payer Solution Software implementation services
Building on the success of the DIAMOND® claims systems, Dell Perot Systems' payer solution software provides increased flexibility through its SOA interfaces. This solution provides enhanced automation and auto adjudication, and it integrates effectively with other payer systems and trading partner systems. Dell Perot Systems provides maintenance services for the existing claims adjudication application (DIAMOND 950/725 software, LRSP, or other) while the payer solution software application is implemented and integrated with satellite applications and trading partner systems.
DIAMOND® 725/950 support services
Dell Perot Systems' DIAMOND solutions for health benefits administration provide health insurance companies and managed care organizations of all sizes with a flexible, function-rich core administration system designed to support the need for real-time, member-focused, self-service information. Dell Perot Systems' core product team maintains the various releases of DIAMOND from client server to enterprise solutions and ensures complete support from bug fixing to enhancement and maintenance of the product at the client location.
HIPAA-compliant care-management solutions
Regulatory compliance in the $1.2 trillion U.S. healthcare market is a major concern of industry members, and it is mandatory for organizations, vendors, and payers to be HIPAA-complaint in their processes, systems, and electronic documents. Dell Perot Systems can help you perform gap analysis and implement solutions to help improve regulatory compliance. We have performed assessments and development work (like EDI for claims) for payers, pharmaceutical distributors, logistics firms, providers and pharmacies. As part of EDI – HIPAA electronic standard transactions, we have implemented 835, 837, 270/271, 278, 276/277, 834, and 820 EDI transactions.
Remote maintenance and enhancement of legacy claims processing applications
For Blue Cross and Blue Shield organizations, support for Long Range Systems Planning (LRSP) can be costly due to the scarcity of vendors who understand the U.S. healthcare system and the various BCBS products, including indemnity and managed care. Dell Perot Systems’ offshore development and maintenance support for LRSP systems will help you cost-effectively enhance and maintain your existing LRSP application.
Data warehousing and report-writing
Rationalizing and integrating multiple claims platforms, member sites, provider databases, and other critical business systems for an organization is the key to providing a consistent user experience across an array of products and markets from a single insurer. It is imperative for payer organizations to invest in data warehousing and data consolidation to have a single view of data that will help in generating customer-specific reports using business intelligence tools.
Dell Perot Systems recognizes that reporting and using data effectively is just as important as processing data. Our capabilities in developing and maintaining Operational Data Stores (ODS) and Data Warehouses ensure that end users are able to get the right information at the right time. We can also develop external data stores that integrate data from legacy applications.