1. Insurance Network Fees and Claims InterAccess, Inc

2. Inside the UML The Problem Our client represented in this model is a managed care provider subsidiary of a major international insurance and financial services company conducting business from their New York City corporate headquarters. Recognizing software limitations, declining data integrity, and an enormous maintenance effort regarding their legacy system, our client decided to develop a new system, which could react smoothly to business opportunities and future growth

3. Inside the UML The Requirements Reprice claims by entering claim information and receive a repriced amount for each procedure Load and utilize legacy claim information Ability to review claim information Load proprietary information used in fee calculations Recalculate provider fee schedules annually provider’s fee schedules

4. Inside the UML The Requirements (continued) Maintain provider medical procedures, categories, etc. Assign multiple providers the same fee schedule Load legacy provider’s fee schedules and other related info Automatically approve

5. Inside the UML The Solution Create a PC based system with high end PC Servers to deliver on our requirements Use the Rational Unified Process (RUP) as our software development process Produce use cases to deliver our high level requirements and further identify application functional needs Use Rational Rose 98 to model the system Language development dictated by client - Visual Basic Database development dictated by client - Oracle

6. Inside the UML Rational Rose Model Check out the Insurance Network Fees and Claims Rose model titled insurance.mdl on this CD The file Business Opportunity 6_0.doc on this CD contains additional information about the project The file Reprice Claims Use Case.doc contains sample use case text For more information visit the InterAccess web site – www.interaccesscorp.com