Rexpert History
In early 1991, Great Valley Technologies undertook the development of a new generation of capabilities which transcended the traditional functionality available in the leading commercial systems. This exciting new product was called Rexpert, the Reimbursement
Expert. Development has been on-going with the first system going on line in September of 1991.
Product differentiation is achieved through Expert processing. The true cost and complexity of a medical billing system is the management of all of the detail information which is required to bill effectively to multiple payors. Rexpert provides the capability for management to decide how a billing expert would handle each situation. That information is recorded in such a way so it is easily maintained. The processing capabilities have been developed which automatically makes the right decision as the billing expert would have done. The burden of handling every unique situation is handled by the Expert logic, and does not fall upon the data entry operator.
The benefits of using an Expert system are significant:
• Each payor is billed accurately using the logic which maximizes reimbursement.
• Each situation is handled consistently.
• There is higher productivity.
• There is a lower training curve for new employees.
• There are lower labor costs.
• There is less of an impact with employee turnover.
• There is Hardware/Software investment protection.
Rexpert was built using industry standards and dependable technology. The system employs PROGRESS 4th Generation Language. PROGRESS is a relational database and has proven to be very reliable and adaptable in many application environments such as DOS and
UNIX. The current price/performance levels of the RISC technology and the database capabilities of PROGRESS database have been employed to record extensive amounts of information on each patient or payor. This information is available to the user for ad-hoc analysis reporting. Through PROGRESS this information can be directly transferred to a variety of PC Accounting, Graphics or Analysis products. Word Processing is performed by
WordPerfect which is directly interfaced for merge capabilities.
Electronic claims processing and electronic payment reconciliation is done directly for Medicare, Medicaid and Blue Shield. Other Commercial Carriers are electronically billed directly or through a clearinghouse. Custom electronic registration through a hospital interface, laboratories and other systems has also been completed. Collection agencies may also accept information electronically.