Qualifacts EDI Project

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Presentation transcript:

Qualifacts EDI Project Adam Davie Clark Bedsole Tim Jansen Robert Jones

CareLogic Web-based application created by Qualifacts and used by the mental health services to organize patient claims Claims are approved and sent to insurance companies Batch files are created and uploaded to the payers’ site

EDI Electronic Data Interchange The method by which information is exchanged between patients, mental health facilities, and insurance companies.

EDI (cont.) Helps save a company money More effective than paper systems Give a company the ability to store and manipulate data electronically with the cost of manual entry or scanning

CareLogic File Format Example ;1744;;;John Doe;;3/27/78+1239.00; Each field represents some data for forms/records Different symbols represent text formatting The formatting is used to generate printed documents In this example: ; characters represent tabs + characters represent new line

Current CareLogic System Structure Changes to the format of one type of file do not propagate to the various sites using the CareLogic system The various files and formats are not organized and labeled The payers determine how their files are formatted and structured Currently no standardized method of formatting

Project Requirements Construct a library of files for the EDI Automate the management of EDI files Addition, deletion, and editing Create a system that automatically propagates changes to the files in the library to all clients that have implemented CareLogic

Databases Structured collection of data stored in a computer system Database Management Systems (DBMS) include dBase, Paradox, Oracle Systems allow user to create, update, extract information from their databases Relational DBMS Relationship among data is stored in form of tables Ex. Matching employee to the department Ex. Employees personal info matched to the specific employee Hash tables are used to gain access to specific data Ex. First + last name

Oracle Oracle database 10g version 10.2.0.1.0 Performance Security Not the newest version Provides the most stable environment Performance Efficient for working with large amounts of data Security Built-in encryption algorithms for protection

PL/SQL Procedural Language/Structured Query Language Programming language designed by Oracle for use with their database systems 4th Generation Programming Language Qualifacts has created a library of functions in PL/SQL that automate the generation of HTML

Source Code Access Connect to Qualifact’s code for CareLogic using a Virtual Private Network (VPN) connection Allows us to work on project away from Qualifact’s office Brad Bills is setting up user accounts for each of us on Qualifact’s network

Revision Control Software Used to manage the editing of source code during a software development project Allows users to check out code modules and check in code revisions We will be using Subversion (SVN) Industry leading version control software Available for free