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Press Release


Practice Alternatives Improves Insurance Billing Process with Progress for Greater Transparency and Improved Customer Satisfaction

Sep 04, 2018   

Built with Progress OpenEdge and Progress DataDirect, new EHR billing application leverages multiple data sources and deciphers complex X12 271 healthcare eligibility/benefits protocols

BEDFORD, Mass.--(BUSINESS WIRE)--Sep. 4, 2018-- Progress (NASDAQ: PRGS), the leading provider of application development and digital experience technologies, today announced that Practice Alternatives, a provider of certified Electronic Health Records Technology (CEHRT), expert billing services, and practice management software for the medical community, leveraged the Progress® OpenEdge® application development platform and Progress® DataDirect®, the industry leading data connectivity solution, to improve its patient responsibility estimate services and provide quick and easy healthcare management for patients.

Patient billing is extremely complex, can be difficult for both patients and providers to decipher, and has high financial stakes for all parties. Prior to using the DataDirect data connectivity solution, Practice Alternatives was only able to provide limited insights in response to patient inquiries about the cost of care. This was due to the X12 271 benefits protocols which are coded messages based on more than 97 code types - the data can be difficult to decode and interpret.

“Deciphering the X12 271 code was a laborious process and keeping up with the ever-shifting code types was nearly impossible,” said Luanne Wainwright, CEO, Practice Alternatives. “We wanted to offer the more than 500 doctors across 70 specialties an easier way to not only manage the billing process, but to provide the right level of information to the patient community. The results have been tremendous as customers have already noted marked improvements in billing operations.”

Practice Alternatives worked with Progress partner, Great Valley Technologies. They selected the OpenEdge development platform to build the new billing application and leveraged DataDirect connectors to access a wealth of data from relational databases, Big Data and the cloud. The new feature, part of their Rexpert application, based on Progress technology, can not only collect the necessary data, but also can decipher the multiple code types, converting the X12 271 string to easily digestible text descriptions automatically.

With the new Patient Responsibility Estimator, responses to patient queries are now intuitive and user-friendly, with detailed information about costs and insurance status. Patients can quickly see whether a certain procedure is covered by their insurance and make more timely decisions on how to best proceed. The end result has been improved billing processes and greater transparency for patients.

“Consumers require the ability to access the information they need, whenever they need it. This is especially important within the healthcare industry as patients often don’t have the luxury of time to make important health decisions,” said John Ainsworth, SVP, Core Products, Progress. “Through the combination of our OpenEdge platform and DataDirect connectors, we’ve been able to help Practice Alternatives deliver an app that removes complexity and delivers maximum transparency for better patient healthcare management.”

To read the full case study on Practice Alternatives, click here.

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About Progress
Progress (NASDAQ: PRGS) offers the leading platform for developing and deploying strategic business applications. We enable customers and partners to deliver modern, high-impact digital experiences with a fraction of the effort, time and cost. Progress offers powerful tools for easily building adaptive user experiences across any type of device or touchpoint, award-winning machine learning that enables cognitive capabilities to be a part of any application, the flexibility of a serverless cloud to deploy modern apps, business rules, web content management, plus leading data connectivity technology. Over 1,700 independent software vendors, 100,000 enterprise customers, and two million developers rely on Progress to power their applications. Learn about Progress at www.progress.com or +1-800-477-6473.

Progress and DataDirect are trademarks or registered trademarks of Progress Software Corporation and/or one of its subsidiaries or affiliates in the US and other countries. Any other trademarks contained herein are the property of their respective owners.

Source: Progress

Progress
Kim Baker, +1 888-365-2779
pr@progress.com