Custom

Case Study for CODeXACT

Client Overview

Parses, Inc., based in Tampa, Florida, powers the CODeXACTSM service, which is
a new method of providing cost management and profit improvement solutions for
the healthcare marketplace. Leveraging technology and a highly trained work force,
Parses helps to ensure correct payments, in a market of over $200B, to physician’s
for patient Evaluation and Management “E/M” services. The CODEXACTSM service
offers a unique method for reviewing large volumes of E/M claims solely on the
basis of physician-supplied records and notes, utilizing automated coding tool,
integrated workflow and database technology.

The Challenge Parses wanted to develop a comprehensive online service powered that provides fair, data driven, professional audits of the actual medical record in order to assess the correctness of physician billing and payment and to provide physician education. Parses provides E/M services for many different clients each with unique requirements. Each client has their own pricing model and the challenge was to develop a flexible model that can accommodate different pricing structures. .

Tecra Solution Tecra developed CODeXACT system using a scalable architecture based on RUP methodology. The solution is designed to support distributed database architecture for high scalability as new clients are added to the system.
Tecra implemented service oriented architecture to handle interfaces with external systems:

  • for automatic communication with physicians using secure fax and email and pricing 
  • for pricing of audits

Tecra is involved in the implementation of this solution right from requirements capture phase to conceptualization, design, development, and migration and transitioning.

Technology CODeXACT is based on J2EE technologies running on IBM WebSphere Application Server and Oracle 10g database server.

Result

Adding and managing multiple clients made easy.

Data separation for each client with distributed databases.

Easy automated communication with providers.

Sophisticated templating feature for customized letters for each client and communication type.

Flexible pricing structure.