Besler BVerified℠ Solutions and Inventu Viewer+ enable timely and accurate Medicare payments
Besler is a healthcare financial and operations consulting company with over 175 clients in 20 states. Many of Besler’s customers are acute care hospitals, who use Besler’s BVerifiedSM suite of cloud-based solutions to ensure that they are paid what they deserve for the services they provide. The BVerifiedSM applications need quick and efficient access to the Medicare Common Working File, information stored on 14 mainframes operated by the Centers for Medicare and Medicaid Services. The Common Working File is the repository of beneficiary demographics, eligibility and billing information.
A large percentage of day-to-day administration work, including such familiar activities as healthcare claims, is processed on large mainframes. These systems have long been the true workhorses of major agencies and corporations. Their efficiency and ability to store and process large data sets have preserved their role, along with the screen-based applications they run. Integrating these older systems into modernized processes can be challenging, a problem made worse by the obsolescence of many screen-based tools. One company, Inventu, has continued to support and improve those tools with their Inventu Viewer+ product, which has emerged as the obvious choice for mainframe integration.
Delays, complications and errors in integrating Medicare data with billing can be a major source of long and complicated payment cycles, wasteful rework and potentially lost revenue. Getting to the information fast is critical, since the government enforces stringent timeframes to correct errors. With a mix of Medicare systems running CICS under MVS, IBM 3270 emulation, Unicenter CA-TPX and EDS, the team at Belser faced a variety of sticky mainframe data integration challenges.
Jim Hoffmann, Chief Technology Officer at Besler is tasked with developing solutions that enable Besler's customers to cope with changing regulatory compliance and reimbursement functions. Jim and his team began searching for a powerful mainframe integration tool. "We needed a tool that would provide the flexibility and productivity to allow us to quickly build the access to the various systems and make it easy to make changes as needed," says Hoffman. He and his group looked at a number of alternatives, but chose Inventu Viewer+ largely because it incorporates literally decades of experience in mainframe integration problem solving. "The argument is always made by software developers that rolling your own tool gives you flexibility and control that cannot be found in a purchased product. When it comes to Inventu Viewer+, this is simply not the case. In the end, the flexibility, native Visual Studio integration and the built-in years of experience in accessing mainframe systems to which we gained access, led us to select Inventu Viewer+," observes Hoffman.
Performance and scalability are critical to Besler's customers, and Inventu Viewer+ helps them deliver. According to Jim Hoffman, “The scalability of the Server, along with Besler’s proprietary code, allows us to process data at a very high rate. In addition, the licensing model allows us to easily expand the processing capacity of our products and servers as needed.” The Besler engineering team also enjoyed Inventu Viewer+’s many “out of the box” features, combined with the product’s support for object-oriented finite state logic. Inventu Viewer+’s ability to easily map screens to objects was also a big plus for the Besler team. “We liked that Inventu Viewer+ takes the object-oriented model down to the screen level. It allows us to map the various mainframe screens to objects, while still giving us access to the raw data stream when needed,” says Hoffman.
The Besler team’s experience with Inventu Viewer+’s ease of use and built in automation reflects many years of development experience rolled into the product. “After gaining such a thorough, hands on understanding of mainframe integration we have a product that really reflects and anticipates the needs and thought patterns of developers. We’ve eliminated the drudgery, painstaking details and frustrations so common to older generations of screen integration tools. That’s why, with a few web mentoring sessions, a bright developer can experience rapid success. It was rewarding to see that take place with the Besler team,” states Bill Thorne, Inventu’s President and Chief Technology Officer.
These built-in features, refined over many years of mainframe integration experience, allowed Besler to quickly access and mine the mainframe screens and data, thereby greatly shortening their development cycle. Besler’s Jim Hoffman sums it up; “We were able to go from concept to design to development to implementation in hours and days instead of weeks and months. By integrating a visual screen mapping tool with well designed generated C# code, the pain of mainframe screen scraping is definitely a thing of the past. The flexibility of the viewer, the graphical field mapping and the generated code made very complex tasks trivial. Inventu Viewer+ encapsulated the complexity of the mainframe and allowed the developers to focus on a proper object oriented design to store the data. Additionally, the integration with Microsoft Visual Studio and the C# language allowed us to quickly design, build, test and deploy solutions.”
All of the Inventu Viewer+ tools and runtime environment are targeted at .NET developers. The Besler team’s familiarity with the .NET Framework and Visual Studio makes Inventu Viewer+ look and feel natural and predictable to them, and that was a key to their success,” observes Bill Thorne. Since Inventu Viewer+ Studio generates complete Visual Studio Solutions for any version, the Besler developers were able to debug, test and tweak in a completely familiar environment and framework.
Inventu, Inventu Viewer+’s exclusive North American distributor and development partner, also provided developer-level support to Besler during the development process. Jim Hoffman cites Inventu’s ability and readiness to help solve vexing problems; “I cannot say enough about the technical support we received from the Inventu staff. Accessing the volume of data required by the Besler software provided a number of interesting challenges, and we received excellent support and advice from the Inventu team. They know their product and were very eager to help when needed.”
The bottom line for both Besler and the hospitals they serve is a powerful return on investment story. Prior to the implementation of Besler’s tools and Inventu Viewer+, a typical hospital review of this data took between 3 and 4 weeks. Today a review of this amount of data is completed in less than 4 hours. This represents huge cost savings, which are amplified by the fact that Belser clients are able to bring these processes in-house vs. engaging a third party to provide the reviews. In addition, the streamlined process allows Besler to review a greater number of claims, more types of claims, and to identify additional opportunities. Says Jim Hoffman “The feedback has been very positive. Our client hospitals are very impressed with the speed and ease of use of the tools we have provided, which at the same time ensure higher accuracy.”