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ADI Generates Winning Results, Cost Effective Integration, Interface with AAJ Technologies

SUMMARY:

A national healthcare and dental services provider, Atlantic Dental, Inc., streamlined their claims processing system by implementing a Web-based application.

The system was developed with future expansion in mind, and to support additional new companies and subsidiaries under the parent company’s umbrella.

 

BENEFITS:

  • Drastic reduction in claims processing time

  • Increased efficiency in claims processing

  • Seamless integration with business partners

  • Maintenance and tracking of accounting transactions

ADI was purchased by DentaQuest.  

THE AAJ CHALLENGE:

Atlantic Dental, Inc. is a national dental provider operating a nationwide network of dentists. They required a state of the art operations system to meet their goals exponential growth.  The company enrolls thousands of new members each month with the objective of providing a feature rich back-end management system and utilize the web to offer services and online information to members, providers, and agents.   The company’s additional requirement was to cut down processing time in their existing legacy system in order to provide better overall service and user experience to members, providers, and agents.

AAJ TECHNOLOGIES SOLUTION:

AAJ Technologies developed a solution utilizing ASP.Net, Web Services, SQL Server, XML, IIS, and Crystal Reports. The project included back-end functionality as well as an external interface to the client data. The major system modules include Member, Provider, Agent, Customer Care, Accounts Receivable and Accounts Payable modules, a role-based Security module, and a Claims module with integration to Clearinghouses.

The system was developed with future expansion in mind, and to support additional new companies and subsidiaries under the parent company’s umbrella.  

Additionally, a new web/ecommerce site was developed that allows members, agents, and providers to purchase, submit, retrieve, view, and register services and products via the web.

WINNING RESULTS:

  • Closing process used to take 72 hours to finish in the legacy system; now takes less than one hour to complete.
  • Instant access to fraud detection and trend analysis reporting that was not available before.
  • Efficient and cost effective interface/integration with business partners utilizing BizTalk and HIPAA Accelerator.
  • Developed rule based claims processing system to process claims efficiently and without manual intervention.
  • ADI was subsequently purchased by a subsidiary of DentaQuest.  

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