1. Qualifacts EDI Project
Adam Davie
Clark Bedsole
Tim Jansen
Robert Jones

2. 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

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

4. 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

5. CareLogic File Format Example
;1744;;;John Doe;;3/27/ ;
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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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