* Modified its legacy claims system to implement EDI so that its bill review vendor could be paid electronically each month.* Created a nightly EDI claims feed to its bill review vendor.
* Modified back-end systems to receive a nightly EDI feed from its bill review vendor in order to auto-pay medical service providers.
* Built a medical bill queue in its electronic claim file to give its bill review vendor immediate access to images of bill documents.
* Designed and implemented an optical character recognition workflow system for its explanation of reviews so they could be drop-filed into the electronic claim file.
* Created a nightly EDI feed to its pharmaceutical and durable medical equipment vendors.
* Modified back-end systems to receive nightly nurse case manager notes from its utilization review and telephonic case management vendors.
* Modified the claims system to automate transactions on funded policies.
* Created a Web-accessible database of nurse case managers.
* Created a Web-accessible database of attorney case managers.
* Created an around-the-clock claims reporting service with an outside vendor.
* Implemented an EDI feed to its claims reporting vendor.
