A Good Dental Plan: Imperial Technology Solutions Uses HostFront Publishing to Provide Heathcare E-Business Solution

Delta Dental gets a new online verification sytem for its patients, while becoming a revolutionary in the healthcare industry.

Like any other industry, the healthcare industry is focused on reducing costs and improving receivables. In this regard, the healthcare industry looks to Imperial Technology Solutions (ITS) to bring about those desirable ends. ITS, the software development and deployment division of Imperial Bank of California, develops industry-leading financial transaction solutions that are designed to enable healthcare providers to electronically verify and automate the collection of patient receivables. These e-commerce solutions for hospitals, dentists and other medical professionals are part of the Receivables Payment Manager (RPM) product line, a product line which is revolutionizing the healthcare billing and collection industry.

By fundamentally changing the process of patient benefits approval and payment for healthcare providers, the RPM product line has proven to drastically cut workflow associated with patient-payment collection, posting, reconciliation and billing. RPM reduces the entire process to just seconds!

Moreover, RPM software also speeds income to the providers within hours, as opposed to days or months. Enabling time-of-care collection and processing of patient receivables, the RPM solution can be precisely measured at the provider’s bottom line. The Receivables Payment Manager software package "has been proven to drastically cut costs associated with patient payment collection and benefits authorization," notes Debra Hubers, President of ITS. With its proven Receivable Payment Manager product line, Imperial Technology Solutions is helping hospitals, dentists and other types of medical offices better manage patient healthcare benefits and point-of-care payments.

Creating the Plan

Because of its proven track record in the healthcare payments and collection industry, ITS was commissioned by Delta Dental Plan of California, one of ITS’ premier customers, to provide secure remote access to the patient eligibility records in each of its clinics. Delta Dental is California’s largest dental health plan with more than 10.6 million California enrollees and 22,000 dental offices throughout the state. This insurance organization uses two IBM mainframe computers located in their Sacramento complex to store all their patient eligibility records. Accessing those records remotely was of primary importance to Delta Dental.

Drawing from experience with similar installations, ITS proposed using a Point of Sales (POS) device at the front end that would dial directly into a CompuServe Network and access both of Delta’s IBM mainframe computers at the back end. Once the patient eligibility record had been retrieved from the mainframes, the record would then be interpreted, formatted and returned to the POS device for printing. ITS discovered that retrieving the data and determining a patient’s eligibility required the construction of a unique transaction server that could selectively navigate through the mainframe screens and interpret the data to determine the patient’s eligibility and dental coverage.

Ultimately, the goal of this proposal was to help dental offices reduce their account receivables, eliminate piles of paperwork and streamline dental office administration for their patients.

However, due to their limited experience with mainframe computers, ITS decided to seek outside expertise to help develop a complete solution for Delta Dental. After approaching several vendors, ITS contracted Farabi Technology Corp., a developer and manufacturer of 5250- and 3270-connectivity solutions, to design a customized multifunction online electronic verification system for Delta Dental, based on its Web-to-host gateway products, HostFront for the Mainframe and HostFront Publishing.

To that end, Farabi developed a dedicated TCP/IP-based transaction server and Computer Gateway Interface (CGI) to service the point-of-entry requests from the remote POS devices. The HostFront transaction server was designed to manage concurrent requests from POS devices, which are located throughout the CompuServe domain. The Point of Sales’ CGI was incorporated within the HostFront transaction server, thereby bypassing the traditional Web server as the point of entry and thus allowing the CGI to communicate directly with the HostFront Session Manager. Once the connection between the POS device and the HostFront Session Manager was established, a script was executed, using HostFront Publishing to automate the process of retrieving patient-eligibility information from the appropriate IBM host. The selected data was retrieved, formatted and returned by HostFront Publishing to the POS device for printing.

HostFront for the Mainframe, the middle-tier server component of ITS connectivity solution, is a collection of native Windows NT 4.0-based services that provide Delta dentists with access to both mainframe hosts over the Internet using a POS device or a Windows 9x-based computer. Operating in conjunction with Microsoft SNA Server to establish an SNA connection at the back end with Delta Dental’s mainframe hosts, HostFront provides Delta Dental with a natural protocol boundary that shields the IBM hosts from the risk of intrusion. With the powerful synergy of HostFront and Microsoft SNA Server, ITS’ client can have complete confidence in the integrity of their e-business transactions.

Security Checkup

Security – among other criteria – was an important factor in ITS’ decision to go with Farabi’s gateway solution. "We needed a product that was secure, easy to implement and intuitive to manage for mainframe connectivity. HostFront and SNA Server were the best fit for our needs," states Ray Fricke, Vice President of Integration at Imperial Technology Solutions.

Since HostFront uses Microsoft SNA Server to connect to an IBM mainframe at the back end, Delta Dental’s mainframe hardware and network connections required no modifications. Their architecture did not require any additional host resources or expensive CPU cycles, nor did it require a specific operating system release. Microsoft SNA Server provided the robust back-end connection to the host, while HostFront Server provided the secure TCP/IP-based front-end connection. HostFront acts as a gateway between Microsoft SNA Server and the medical practitioner’s POS device, controlling access and managing the communication.

HostFront for the Mainframe distributes processing among multiple hosts, the server and the client PC or POS device to ensure the operational efficiency of the entire system. As a gateway, HostFront Server reduces demand on the host’s resources and handles system administration.

The HostFront Server Console configures and manages the server and the clients, and is the central point for system security. The maximum number of active and background sessions, time-out periods and trace functions are determined using the console. Users’ passwords can be changed or set to expire. The Server Console features three components: one, the Network Connections window; two, the Server Message Log; and three, the Server Statistics window. The Network Connections window graphically shows host and client connections. The HostFront Server Message Log displays time-stamped, color-coded messages describing server and client events as they occur. The Message Log can be saved, appended to a file or printed. And, finally, the Server Statistics window shows server load, usage history, scheduled shut down times and more.

The front-end component of ITS’ solution, HostFront Publishing, is the development environment that allows Delta to publish mainframe data on the Web in a familiar HTML format, or in a proprietary format such as a POS device, without making any modifications to the host or its applications. HostFront Publishing adds a middle tier of processing between legacy applications and the Web for the purposes of creating e-business solutions. Host information can be published using an output device, such as a POS printer or a standard HTML Web page, and information from an HTML page or any programmable input device can be inserted within host applications. In effect, HostFront Publishing transformed Delta’s online business into the core of its e-commerce strategy.

Follow the Script

HostFront Publishing uses simple scripts to act as the go-between for input/output devices (such as a Web browser) and the host. The scripts, developed using either Active Server Page or Farabi Script Language, interact with the host and perform such tasks as signing on, navigating from screen to screen and inserting data into fields.

The scripts also control how the host information will be presented to the user. Using a scripting environment is easy and flexible; the content of screens can be combined, screen navigation can be controlled and functionality added without touching the host applications.

As part of the overall Delta Dental Patient Eligibility solution, scripts were developed using Farabi Scripting Language (FSL) which is executed through Farabi HostFront Publishing. The FSL scripting environment was enhanced to support a rich set of text formatting and character manipulation. The enhancement was required for the interpretation and presentation of the eligibility report to a requesting POS device.

Enabling a wide variety of connectivity options to host resources, the flexibility and reliability of HostFront allowed ITS to implement the technology to support programmatic access to a variety of mainframe systems.

The benefits of ITS’ interoperability solution are just beginning to be realized by the healthcare industry. In addition to providing options for immediate reimbursement at the point-of-care, Hubers noted that "the insurance carriers also benefit indirectly by reducing the volume of incoming calls, resulting in savings between $7 and $10 for each call."

With Microsoft SNA Server providing the robust back-end connectivity to the insurance carrier’s host systems and HostFront programmatically managing transaction requests, the Receivables Manager Payment product line will continue to revolutionize patient payment and eligibility approvals. With new hospitals, medical and dental offices joining with ITS each week, the average healthcare provider is seeing increases in point-of-care revenue payments up 278 percent and ITS plans to have its transaction volume grow by 300 percent by the end of 1999.

About the Author: Charles Machalani is Director of Marketing at Farabi Technology Corp. in St. Laurent, Quebec, Canada. He can be reached at charles@farabi.com.