Market Overview

Practice Alternatives Improves Insurance Billing Process with Progress for Greater Transparency and Improved Customer Satisfaction


Built with Progress OpenEdge and Progress DataDirect, new EHR billing
application leverages multiple data sources and deciphers complex X12
271 healthcare eligibility/benefits protocols

(NASDAQ:PRGS), the leading provider of application development and
digital experience technologies, today announced that Practice
, a provider of certified Electronic Health Records
Technology (CEHRT), expert billing services, and practice management
software for the medical community, leveraged the Progress® OpenEdge®
application development platform and Progress® DataDirect®, the industry
leading data connectivity solution, to improve its patient
responsibility estimate services and provide quick and easy healthcare
management for patients.

Patient billing is extremely complex, can be difficult for both patients
and providers to decipher, and has high financial stakes for all
parties. Prior to using the DataDirect data connectivity solution,
Practice Alternatives was only able to provide limited insights in
response to patient inquiries about the cost of care. This was due to
the X12 271 benefits protocols which are coded messages based on more
than 97 code types - the data can be difficult to decode and interpret.

"Deciphering the X12 271 code was a laborious process and keeping up
with the ever-shifting code types was nearly impossible," said Luanne
Wainwright, CEO, Practice Alternatives. "We wanted to offer the more
than 500 doctors across 70 specialties an easier way to not only manage
the billing process, but to provide the right level of information to
the patient community. The results have been tremendous as customers
have already noted marked improvements in billing operations."

Practice Alternatives worked with Progress partner, Great Valley
Technologies. They selected the OpenEdge development platform to build
the new billing application and leveraged DataDirect connectors to
access a wealth of data from relational databases, Big Data and the
cloud. The new feature, part of their Rexpert application, based on
Progress technology, can not only collect the necessary data, but also
can decipher the multiple code types, converting the X12 271 string to
easily digestible text descriptions automatically.

With the new Patient Responsibility Estimator, responses to patient
queries are now intuitive and user-friendly, with detailed information
about costs and insurance status. Patients can quickly see whether a
certain procedure is covered by their insurance and make more timely
decisions on how to best proceed. The end result has been improved
billing processes and greater transparency for patients.

"Consumers require the ability to access the information they need,
whenever they need it. This is especially important within the
healthcare industry as patients often don't have the luxury of time to
make important health decisions," said John Ainsworth, SVP, Core
Products, Progress. "Through the combination of our OpenEdge platform
and DataDirect connectors, we've been able to help Practice Alternatives
deliver an app that removes complexity and delivers maximum transparency
for better patient healthcare management."

To read the full case study on Practice Alternatives, click here.

Additional Resources

About Progress
(NASDAQ:PRGS) offers the leading platform for developing and deploying
strategic business applications. We enable customers and partners to
deliver modern, high-impact digital experiences with a fraction of the
effort, time and cost. Progress offers powerful tools for easily
building adaptive user experiences across any type of device or
touchpoint, award-winning machine learning that enables cognitive
capabilities to be a part of any application, the flexibility of a
serverless cloud to deploy modern apps, business rules, web content
management, plus leading data connectivity technology. Over 1,700
independent software vendors, 100,000 enterprise customers, and two
million developers rely on Progress to power their applications. Learn
about Progress at or

Progress and DataDirect are trademarks or registered trademarks of
Progress Software Corporation and/or one of its subsidiaries or
affiliates in the US and other countries. Any other trademarks contained
herein are the property of their respective owners.

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