Issues With Dshs Billing System Push Firm To Brink

Redknee Launches Converged Billing at Japanese Multi-Play Operator iTSCOM

It replaces a 32-year-old payment system for Medicaid, a shared state-federal health insurance program that serves low-income parents, children, seniors and people with disabilities. The new system software, built by Rockville, Md.-based CNSI, is intended to reduce errors, overpayment and fraud, and to reduce paperwork by offering user-friendly, online services. The federal government is paying for 90 percent of the cost of implementing the system and is expected to pick up roughly 75 percent of its operational costs. The concerns raised by Care Medical and other businesses in Washington echo problems that occurred in 2005 with a troubled system CNSI built for Maines state government to process $1.5 billion in annual Medicaid claims and payments. That systems hiccups triggered an unusually high rate of rejected claims, forcing several dentists and therapists to shutter their doors and turning away tens of thousands of Medicaid recipients, according to an April 2006 article in CIO Magazine, a publication for information technology executives, which extensively outlined Maines problems. But DSHS officials say ProviderOne is exceeding expectations and performing well, with payment levels normal and only a small subset of businesses citing problems. In 2012, DSHS expects to extend the same payment system to social programs. Payments plummet Robbins Brown said her department did extensive outreach to health care providers to help them with the new system and conducted thorough training and testing with 90 percent of those providers. During testing, Stevenson said, Care Medical submitted 25 claims, of which 16 were paid. Clearly, they still continued to have problems once we went live with filing claims, Stevenson said. Lee of Care Medical said thats an understatement. Care Medical had no problems with DSHS former billing system, he said, but when ProviderOne went live all hell broke loose. Before ProviderOne took effect, Care Medical brought in a monthly average of about $370,000 from its Medicaid billings, Lee said.
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Impact of New Billing & OSS Systems on Existing Processes

"Every Website has to be able to reach into the billing and CRM systems to get information," Michie says. "That being the case, you've got to allow Web sites to reach into both and extract that data." Given all the systems that rotate around the billing system, and the other satellite systems such as Websites (some carriers have dozens), Michie suggests moving a copy of the voluminous billing customer data to a neutral storage device where it can be cleaned and prepared before conversion. A lot of companies take the architectural purist approach, which is to pull the data out of the billing system and put it in a central warehouse where they can manipulate it. "So now the billing, the CRM and other supporting systems can grab from this centralized depository," Michie says. This storage "bin" can be temporary until the data is cleaned, vetted, tested and returned to the new billing system, or it can become a permanent repository from which CRM staff, billing employees, financial managers and provisioning services can pull data. There's another reason the data storage could be moved from the billing system: to make it more accessible to CRM operations. Daniel Kenyon, manager of communications industry solutions at PeopleSoft, believes the customer account information should be stored within the CRM so CSRs don't have to dig for customer information in the billing system. "Before, all you could do is track account history," Kenyon says. "Now they want to track customer behavior, but that information has resided within the billing applications." But moving the reservoir of customer data from the billing system to another place in the architecturethe CRM in this casechanges the overall mapping of the business processes. Impact on Existing Customer Data The heart of the carrier's business is the data attached to each customer's name: not just billing and address information, but the services and plans customers expect to receive and the rates they're expecting to pay.
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Total Benefit Solutions Selects VUE Software and Goes Live With Billing System in Five Months

After an extremely rapid implementation, VUE Billing & Collections went live in just five months. This flexible multi-carrier platform enables TBS to manage billing and collections for AetnaSM and other carriers it serves. A Managing General Agent (MGA) for Aetna in Washington state and Alaska, TBS contracted to handle Aetna's billing and serve as the carrier's Third Party Administrator (TPA). Planning on launching a billing and enrollment division, TBS required a robust, comprehensive and user-friendly billing system for invoicing customers on Aetna's behalf. With VUE Billing & Collections, TBS can now handle virtually any billing scenario, serve multiple carriers and include products from various carriers on a single bill. "We performed an exhaustive search for the perfect partner for our TBS billing platform and are pleased to have selected VUE Software. VUE Billing & Collections, with its real-time billing, customer portals and easy broker access, was clearly the ideal choice. The system is customizable and configurable, which will help us continue to meet the need of our clients with the rapidly changing market," said Mike Crosetto, COO at TBS.A"The VUE Software team brought both information technology expertise and industry-specific knowledge to the table, quickly responding to our needs, listening to what we wanted and successfully making it happen.AThis rapid-go-live attitude has allowed us to fulfill our promises to our carrier partners and our clients." TBS' goals include excellent service, a positive customer experience, an effective channel, and customer and producer retention. VUE Billing & Collections supports these extremely well. Billing system implementations can take six to nine months, so the aggressive five-month timeframe gives TBS a head start.
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Joburg online billing system maliciously hacked: CoJ

Gerd Naschenweng For more information about Redknee and their solutions, please go to . Forward-Looking Statements Certain statements in this document may constitute "forward-looking" statements which involve known and unknown risks, uncertainties and other factors which may cause our actual results, performance or achievements, or industry results, to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements. When used in this document, such statements use such words as "may," "will," "expect," "continue," "believe," "plan," "intend," "would," "could," "should," "anticipate" and other similar terminology. Forward-looking statements are provided for the purpose of providing information about management's current expectations and plans relating to the future. Persons reading this news release are cautioned that such information may not be appropriate for other purposes. Such forward-looking statements include the statements regarding financial and other projections as well as statements regarding Redknee's future plans, objectives or performance for the current period and subsequent periods and regarding the markets for our products. These statements reflect current assumptions and expectations regarding future events and operating performance and speak only as of the date of this document. Forward-looking statements involve significant risks and uncertainties, should not be read as guarantees of future performance or results, and will not necessarily be accurate indications of whether or not such results will be achieved.
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Selecting the right billing system

You dont have to spend four years studying computer science in addition to medical school to determine which billing system will best suit your needs. There are, though, a number of factors to consider when deciding to purchase a new or upgraded software package to handle your billing needs, and every physician should take the time to do their homework when making this crucial decision after all, the billing systems capabilities are the framework for bringing a healthy cash flow into the practice. Some important initial questions you should ask of any potential vendor of billing software and hardware include: How long has Company XYZ been in business? What is the history of the company? How long has the particular software package youre interested in beenon the market? How many and what types of practices use their software? Are client references available for you to call? Are demo disks of the software available? What is the availability and accessibility of system set-up, training and support, as well as the approximate cost of these essential items? Does the company have the capability to import data from your previous billing system if necessary, what is the cost for this service, and have they been successful with this? What are the hardware and networking requirements recommended by the software vendor for optimum efficiency? What is the cost of their basic system and what is included? What additionalproducts are available at an extra charge to enhance the basic software package?
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Robert Lee, director of government affairs and health policy analyst for Care Medical & Rehabilitation Equipment, stands in the company’s storage area, where wheelchairs and other medical equipment are located, inside its Vancouver office. Speaking on Radio 702, Mahlangu said that a COJ website user was behind the hack, and after accessing the system went on to look for access to other accounts. Straight from the horses mouth The person who blew the whistle on the security problem with the City of Joburgs online billing system, BidorBuy CTO Gerd Naschenweng , tells a very different story. Naschenweng said that he discovered the COJ billing system problem at 11:00 on Tuesday 20 August 2013. I wanted to print my Joburg statement, and when I clicked on the link to view the statement, I noticed the URL parameter being the same as my invoice number, said Naschenweng. I then incremented my number by 1 to see what will happen, and was surprised to see that some other persons statement was displayed. He said he then tested the same link in another browser where he was not logged in, and he could still view someone elses statement. Naschenweng became concerned about this security vulnerability, and phoned the COJ call-centre and asked the agent to connect him with IT or anyone who is responsible for the website. However, Naschenweng said he was told by the agent that they could not connect him. I then asked to speak to a supervisor as the agent could not comprehend the urgency of the problem and the call-centre agent refused and put the phone down, he said. I then submitted an email to COJ, but I did not expect an urgent response, said Naschenweng. After he failed to raise the alarm directly with the COJ, Naschenweng highlighted the problem on the MyBroadband forums. Other MyBroadband members quickly validated the findings, and a MyBroadband news article followed. Gerd Naschenweng Naschenweng not happy Naschenweng is not happy about the COJs allegations that a malicious attack was to blame for the COJs online billing security woes.
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