New software from Vitria Technology Inc. aims to extend the capabilities of health care adjudication systems.
The Vitria:SmartClaims offering helps end users manage and easily modify complex and dynamic business rules and processes specific to the health care industry and to automatically repair claims.
Specifically, the software, due later this month, enables users to write rules in a simple, intuitive business language so they can be changed and managed by non-IT professionals such as business analysts and front-line supervisors.
Health care insurance organizations can take as long as six months to make changes to their legacy claims systems to accommodate constantly changing business rules, according to officials at Vitria, in Sunnyvale, Calif.
Vitria:SmartClaims, which includes the companys business process management platform and business rules engine, enables more consistent decision making, with better exception handling and quality control.
At the same time, Vitria: SmartClaims fuses to legacy systems, simplifying and speeding system updates resulting from changes to government regulations and health care contracts, officials said.
The health care software is based on Vitrias BusinessWare business process engine.
BusinessWare provides an environment where every component is not only accessible but also linked and executable, Vitria officials said. The business process engine provides tools so that users can manage the life of an integration project and—as processes change through the design, test, execution and analysis phases—change the project.
“Its about the business process, not just connecting applications, trying to make [software] as agile as possible,” said Dale Skeen, Vitrias chief technology officer. “To take the cost out of business process [management] you do that through infrastructure and pre-built integrations.”