Naming its cloud-based reimbursement solution Fine Rezept, in deference to the statement of Japanese medical expenses and details, Rezept, ISB began development in August 2014 and launched a pilot program the following spring. Mr. Miyagi estimates that Corticon allowed them to build Fine Rezept about 30% faster than with other rules engines.
“Now that Fine Rezept is built and being tested, I estimate we sped development time by about one-third and expect an improvement in revenue because we now have the ability to centrally manage reimbursement rules, streamlining the business,” he said.
For providers, the benefits of Fine Rezept are significant as well. Mr. Masanobu Ohashi, Senior Manager of ISB, explained that each month providers submit reimbursements based on medical fee rules, which they used to have to manually score before submitting—a process prone to human error. Fine Rezept, now with Corticon, automates the process, ensuring accuracy before invoices are submitted.
“Corticon business rules help validate invoices based on medical fee point definitions ensuring their accuracy before processing,” Mr. Ohashi said. “The system will automatically flag inaccurately recorded items, dramatically speeding payment.”
With Fine Rezept about to complete the test phase and go live, Mr. Saito summed up the three key benefits realized with the Corticon BRE:
Changes to medical reimbursement rules, which are reset every two years, can be rapidly implemented, thereby avoiding delays in payments to providers
With business rules separated from code, non-programmers can easily keep pace with ongoing system maintenance and rules changes
Without IT involvement with business rules, ISB anticipates at least a 20% savings in overall maintenance of the system
Finally, the K.K. Ashisuto Corticon support team, in conjunction with the Progress Corticon support team, was instrumental to keeping the project on time and within budget.
“We had an aggressive timeline to develop Fine Rezept,” said Mr. Saito. “Whenever we had questions or hit a roadblock the Corticon support team was always available, helping us keep the project on schedule.