Installations
Installations
• Cognizant Technology Solutions (CTS; Teaneck, NJ), an applications outsourcer providing software development and maintenance services, has entered into a multi-phase agreement to provide a range of application outsourcing services to HealthNet (Kansas City, MO), a healthcare organization. HealthNet offers a full complement of health maintenance organizations, preferred provider organizations, point of service plans, and other programs to 363,000 members in Kansas, Missouri and the surrounding areas. Under the multi-phase agreement, CTS will facilitate data mapping to Facets, design and develop Facets interfaces and create and implement a number of other enhancements to Facets running on an IBM RS 6000 client/server platform. Project work for HealthNet will be done using CTS’ on-site/offshore project execution model. System design and development work will take place at a CTS development center in India, while specifications, user interface development, system testing and integration, will take place on-site at HealthNet’s Kansas City location.
• GTESS (Dallas) said that it has received a contract from Health Care Resources (HCR; Las Vegas) to process paper claims in the GTESS Claims Factory. GTESS’ Claims Factory service includes scanning the paper claims, extracting the necessary data from the images of the claims and then transmitting the extracted data as an EDI record to Health Care Resources’ claims processing system for final processing and payor distribution. HCR-Benelink is a claims clearinghouse which facilitates the EDI for the provider to the payor. The GTESS Claims Factory service and the Automated Claims Processing System use imaging and recognition technology to provide automatic scanning, image capture and recognition of paper healthcare claims, and transform the images into either EDI claims or ASCII data for direct submission to claims processing systems.
• Kinetra (Golden, CO), a health information network and electronic business services firm, said that Humana (Louisville) will pilot Kinetra’s web browser-based electronic business solution, Odysent. The first phase of the pilot migrates Kinetra-hosted Humana information to a browser-based platform to assist providers with treatment plans and administrative tasks. In the Louisville and South Florida markets, Humana-affiliated physicians will be able to access online lists of covered drugs, carry out hospital and physician office practice administrative processes, and receive Humana policies and procedures through Odysent. Odysent II offers a suite of managed care transaction sets allowing Humana and its at-risk providers to better manage member care and costs, including but not limited to, eligibility verification, referral processing, claim/encounter submission and claim/encounter status inquiry.
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