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Emdeon Stakes a Claim With Business Objects

"Our business is about making sure that electronic healthcare transactions are delivered quickly and accurately, and that the responses are returned in a timely manner to the customers who need them. The use of Business Objects software clearly helps us maintain our competitive edge."

Gene Boerger
Vice President of Advanced Business Reporting
Emdeon Business Services

CHALLENGE

The number almost defies imagination, but here it is: Emdeon Business Services, the leading processor of healthcare transactions in the United States, distributes up to 800,000 text-based reports a day. Business Objects, an SAP company, is helping Emdeon replace these paper-based reports with Internet access for claims research using Crystal Reports®, Web services, an underlying Oracle database, and the company's own Emdeon Vision application for report distribution and claims processing.

"If a claim is sent electronically, we send text-based reports back to the healthcare providers to track the claims into Emdeon, out to the insurance company, and back to the provider," says Gene Boerger, vice president of advanced business reporting at Emdeon. "Our experience is that these reports are very difficult for the providers to handle. So, with Crystal Reports as a key component, we've developed an electronic solution that allows us to distribute information much more quickly and efficiently. In this way, providers can immediately view the status of any electronic claim in the process."

The major focus of Emdeon's electronic reporting effort is to ensure that customers have access to the information they need, when they need it. But Emdeon was also challenged to deliver an easy to use, efficient reporting system. "The previous application we had for our customer service desk was very limited in the amount of data the agents could pull," says Boerger. "It was difficult to change, integrate, and update the user interface in response to customer demands. The lack of speed and responsiveness was another problem. Worst of all, adding data elements and making other changes to the reports required not a report developer, but a software engineer." Realizing it needed an analysis and reporting solution that offered ease of use as well as rapid delivery of information, Emdeon looked to Business Objects.

APPROACH

Emdeon uses BusinessObjects™ XI along with Emdeon Vision for customer tracking and trending. "We have 12 data sources integrated together using a single Business Objects universe," explains Jaideep Kulkarni, manager of market research. "We use the BusinessObjects system for internal analytical reporting on customer service calls, transaction volumes and trends, claims rejection rates, and similar metrics. We also generate automatic alerts for senior management when values deviate from set levels, so they can quickly analyze the root cause and take corrective action, if necessary." These internal reports are distributed and used via Infoview. Emdeon is also ramping up its use of BusinessObjects Web Intelligence®.

When the software was initially installed, Business Objects Global Services was called in to help remove some latency from the system. "They helped us understand where the bottlenecks were in our implementation," says Boerger. "It was a fairly short engagement, and it was completed on time and on budget. We found it useful in terms of validating our approach. We have also found the online knowledge base very helpful."

RESULTS

"Using the BusinessObjects XI infrastructure, along with enhancing the databases themselves, we were able to create an application that is very fast and very easy to maintain," says Boerger. "The reports can be created by a report developer, so we no longer need to wait in queue for a software engineer. The system also gives us the ability to do rapid prototyping. This is important, because when people request information, they don't always know exactly what they want at first. By using the Business Objects product suite, we can easily go through an iterative process with our customers – and when we're done, the product actually meets their needs."

By enhancing its database infrastructure and moving to BusinessObjects XI, Emdeon has realized a productivity increase of impressive proportions. "Our old application required three full-time equivalents to support a twice-yearly release of new features and functions," says Boerger. "That was a single-user program that focused exclusively on providers. By contrast, Emdeon Vision has four customer segments - internal, provider, payer, and partner – and we're doing roughly 20 releases a year with one Java developer and one-half a report developer. So we've cut the staffing in half, while growing the number of releases by a factor of 10."

Emdeon Vision has been in use for two years and is getting rave reviews. Boerger says, "Approximately one-half of our partner customers are now using the application. The feedback has been nothing short of amazing. For example, MedePresence CEO Dave Dugan writes, 'Vision will definitely drive down errors, while accelerating and automating support for us as your channel partner. Keep up the awesome work!'" This kind of feedback underscores Emdeon's successful transition from paper-based reporting to a more efficient and cost-effective Web-based delivery. Boerger says, "Our business is about making sure that electronic healthcare transactions are delivered quickly and accurately, and that the responses are returned in a timely manner to the customers who need them. The use of Business Objects software clearly helps us maintain our competitive edge."

As an example, Boerger cites the significant improvement in customer service levels that followed the rollout of Emdeon Vision to its partners. "Staffers at one of our largest customers, who represented about 25% of the total call volume into our service center, were suddenly able to answer questions on their own," he says. "Within four months of deploying Vision, their calls relating to claims dropped by about 65%. Having the flexibility BusinessObjects provides as the presentation layer accounts for a big part of this success."

Moving forward, Emdeon plans to further exploit the power of Web Intelligence, and explore the use of dashboards to provide a summary view of key trends. Boerger is also excited about the potential for interactive reporting. "We have our first working application, which we call Provider Work Queue," he says. "This enables a provider who's looking at claims information on a Crystal report to click on a checkbox, clear an error, and update the database right from within the report. This kind of functionality gives our end users greater flexibility while enhancing their productivity."

Whether it's medical claims, dental claims, electronic remittances, real-time insurance eligibility requests, or Health Insurance Portability and Accountability Act (HIPAA)-based transaction sets, Emdeon Vision makes life easier for payers and providers alike. "The success of Vision is a testament to the creativity and technical expertise of our team, and also to the power of BusinessObjects," says Boerger. "Historically, the problem was our inability to present information rapidly to our customers. Using BusinessObjects, we're able to deliver the data multiple ways to multiple customers with multiple security models - quickly and effectively. This enables us to focus on the organization of the information itself, which is a much smarter use of our resources."

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