deNovis Transaction Software Selected by Federal Agency for Overhaul of National Medicare Program.Business Editors and Health/Medical Writers LEXINGTON, Mass.--(BUSINESS WIRE)--Feb. 5, 2003 IBM (International Business Machines Corporation, Armonk, NY, www.ibm.com) The world's largest computer company. IBM's product lines include the S/390 mainframes (zSeries), AS/400 midrange business systems (iSeries), RS/6000 workstations and servers (pSeries), Intel-based servers (xSeries) and deNovis Joint Team Wins Contract to Modernize Medicare Claims Processing Infrastructure for Nation's Largest Health Care Purchaser; Provides Medicare Coverage for Almost 40 Million Americans, Handles $1 Billion in Transactions Every Business Day In a major development aimed at significantly improving the accuracy, efficiency and user-friendliness of claims processing in federal health care programs, the Centers for Medicare and Medicaid Medicare and Medicaid U.S. government programs in effect since 1966. Medicare covers most people 65 or older and those with long-term disabilities. Part A, a hospital insurance plan, also pays for home health visits and hospice care. (CMS (1) See content management system and color management system. (2) (Conversational Monitor System) Software that provides interactive communications for IBM's VM operating system. ) awarded a contract for the redesign, replacement and maintenance of a core Medicare claims processing system component - the Common Working File (CWF CWF Colonial Williamsburg Foundation CWF Canada West Foundation (Economic Institute) CWF Canadian Wildlife Federation CWF Common Working File CWF Christian Women's Fellowship CWF Cool White Fluorescent CWF Campaign for Working Families ). The winning bid was submitted by a team led by IBM and featured deNovis' eHD(TM) enterprise platform and deNovis' HICL HICL Health Insurance Contract Language (scripting language used in health care software) (TM) technology. deNovis, a leading provider of transaction processing technologies for health care insurers and government administrators, with its eHD enterprise-wide transaction platform, is an integral part of the proposal selected by CMS. If fully implemented, the deNovis technology will play a significant role in CMS' future system modernization initiatives. The Medicare technology modernization initiative is expected to save millions of dollars through increased automation, higher levels of accuracy, enhanced capture of fraud and abuse, potential increased use of the Web for self-service functions, and a simplified approach to programming and reprogramming the transaction system's rules and policies. "We've got the best minds in government, technology and health care working together to revolutionize our health care transaction systems," said CMS Chief Operating Officer Chief Operating Officer (COO) The officer of a firm responsible for day-to-day management, usually the president or an executive vice-president. and Deputy Administrator Ruben J. King-Shaw Jr. "Our goal is to leverage advances in technology to streamline and enhance Medicare's operations." As the nation's largest health benefits administrator, CMS needed a system that would scale to handle the growing transaction volumes fueled by an aging population, and be flexible enough to accommodate constant changes in processing rules and unforeseen business demands. deNovis' eHD transaction software is designed to deliver the sophistication so·phis·ti·cate v. so·phis·ti·cat·ed, so·phis·ti·cat·ing, so·phis·ti·cates v.tr. 1. To cause to become less natural, especially to make less naive and more worldly. 2. necessary to meet both existing and emerging needs of government and commercial healthcare benefits administrators. The company's innovative HICL technology allows the system to be programmed by non-technical health plan staff using plain English language commands and the actual policies and business rules of the health plan. According to Jerilyn P. Asher, chairman and co-founder of deNovis, "We specifically designed the product to eliminate the need for costly and time-consuming reprogramming every time a change in health policy or a new quality-improvement initiative created the need to change the transaction processing rules. With HICL you have all the tools you need at your fingertips." The value of the five-year agreement is estimated at approximately $50 million in technology solutions and consulting services. The opportunity beyond this initial contract may be very significant for deNovis, as CMS currently contracts with more than 50 private-sector fiscal intermediaries and other organizations for claims-related processing in Medicare, and plays a key role in financing Medicaid processing systems for all states. Speaking at UBS UBS Union Bank of Switzerland UBS United Bible Societies UBS United Blood Services UBS United Buying Service UBS Used Bookstore UBS University Business Services UBS Universal Building Society (UK) UBS Ulaanbaatar Broadcasting System Warburg's Global Healthcare Services Conference yesterday in New York City New York City: see New York, city. New York City City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. , deNovis President and CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. Bradford Burkett noted, "deNovis has been dedicated to developing a new generation of technologies to make health care benefits processing easier, more accurate and less costly. We're honored by the federal government's choice to license our software, and we welcome the opportunity to apply our solutions to the nation's Medicaid and Medicare programs. We look forward to helping CMS modernize its processing infrastructure and achieve its goal of consumer-centric health care." About deNovis Inc. deNovis develops and sells advanced enterprise transaction technologies and information management solutions for the health care benefits and financial services industries. In the health care sector, the company's highly innovative claims processing and data warehouse software enables government and commercial health plans to reduce administrative costs, expand their range of products and services, increase speed-to-market, and provide the levels of customer service demanded by health care providers, employers and consumers. The company is privately held and is headquartered in Lexington, Massachusetts. Visit www.denovis.com. About the Centers for Medicare and Medicaid Services The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and An agency within the U. S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS , the Centers for Medicare & Medicaid Services has primary responsibility for the nation's Medicaid, Medicare and children's SCHIP SCHIP State Children's Health Insurance Program programs. It is the largest purchaser of health care in the United States Health care in the United States is provided by many separate legal entities. The U.S. spends more on health care, both as a proportion of gross domestic product (GDP) and on a per-capita basis, than any other nation in the world. Current estimates put U.S. , providing healthcare coverage to almost 80 million persons, nearly one in four Americans. CMS assists states in financing and operating the Medicaid program, and contracts with over 50 fiscal intermediaries, carriers, and other contractors to process health care claims for the Medicare program. In 2002, those contractors processed approximately 1 billion Medicare claims. Combined, the Medicare and Medicaid programs account for over $2 billion in health care transactions every business day. The agency has its headquarters in Baltimore, Maryland. Visit http://cms.hhs.gov. |
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