SourcEdge, An Alivia Company, has deep expertise in AMISYS.
What CCOK is Saying:
Rusty Wyrick, VP and CIO of CommunityCare of Oklahoma (CCOK), praised SourcEdge, An Alivia Company, for their years of experience in building and supporting AMISYS-related applications and surround code. He acknowledged the migration to the cloud and the update of their core platform as their top IT project with incredible visibility. SourcEdge’s collaboration with their team resulted in meeting the project timelines and budgets. Extensive testing and planning led to a successful go-live, with most customers being unaware of any changes. According to Wyrick, SourcEdge’s experience and expertise were crucial for the project’s success.
Problem: Outdated Systems
CCOK faced a significant challenge with their outdated HP-UX servers and AMISYS system, which had not been updated in eight years and was three releases behind. The system had been highly customized with surround code to fit their operations, making it more complex to upgrade.
Moreover, all computerized tasks had to be handled on site, and in the event of a disaster, CCOK estimated that its RTO (return to operations) would take a minimum of six months. This made it clear that the existing platform was no longer sustainable, and it was time to modernize and extend the life of their systems.
The capitalization cost of upgrading the servers in a ground-up build would have required a multimillion-dollar capital investment. However, CCOK’s new CIO, Rusty Wyrick, had a different idea. He proposed building a modern, agile, cloud-based platform that would create greater flexibility and infinite scale while reducing capital expenditures.
Achieving buy-in from the leadership team was a massive undertaking, but Wyrick was successful in convincing them of the benefits of a new system. The new system would not only provide greater flexibility and scalability but also reduce the risk of extended downtime in the event of a disaster.
Overall, the outdated systems posed a significant problem for CCOK and required a modern solution that would enable them to keep up with the changing landscape of the healthcare industry.
Solution: Upgrading Hardware, Updating Software, and Moving to the Cloud
The solution to Rusty’s problem involves three key components: upgrading hardware, updating software, and transitioning to the cloud. This process will require work on servers, updates on local workstations, modernizing operating systems, updating Oracle databases, and streamlining disaster recovery options. By implementing these changes, Rusty’s company will be able to improve their overall efficiency and ensure that their technology is up-to-date and secure.
Alivia: Discovering and Modernizing Code for Claim Systems
Results
Alivia, a technology consulting firm, collaborated with the CCOK team to modernize the company’s highly customized system. The project was completed within 14 months, on time and on budget, which allowed the teams to meet their important KPI commitments.
The team successfully upgraded AMISYS through a detailed step-by-step process. They uncovered numerous bugs with the AMISYS version and worked directly with the vendor to resolve all code issues and work through each version to successfully get to the final version. In addition, SourcEdge upgraded the obsolete HP-UX operating system to the current Linux operating system, which was required to run the current version of AMISYS.
SourcEdge’s Oracle DBA expertise was utilized to upgrade Oracle from 12i to 19c. The team migrated the entire AMISYS, Linux, and Oracle environments to the cloud in the Microsoft Azure cloud environment. The cloud migration happened simultaneously with the upgrade project.
The team also remediated 300 surround code applications by thoroughly testing each application and providing SQL coding expertise to develop new code to ensure integration to the current AMISYS version was successful.
Throughout the process, all downstream data was deidentified to protect member privacy and maintain compliance with state and federal regulations. SourcEdge provided consulting, staff augmentation, additional developers, and EDI/configuration experts. They worked hand-in-hand with the client’s IT team and completed the project in just 14 months.
Overall, SourcEdge’s modernization efforts were successful in upgrading the system to be compatible with the new version of AMISYS and the new Linux OS. The team’s expertise in writing new embedded code for the operating system and surrounding code to make the transition work was crucial in achieving the desired results.
Outcome Achieved: A Lightning Fast, Cost-Effective Solution
Benefits
The client’s transition from an old, outdated system to a new, cloud-based system has resulted in a number of benefits. The new system is fast, efficient, and cost-effective, and has enabled employees to work remotely. The disaster recovery plan has also been modernized to support an industry-leading RPO/RTO.
One of the most significant benefits of the new system is the increased performance of the entire claims processing environment. The excess and legacy applications that were no longer needed have been eliminated, and the new system is much easier to support, resulting in significant savings on license fees.
Thanks to the cloud-based system, the client now has a new, remote-friendly work environment. This has allowed the client to avoid hiring additional personnel and the cost of one full-time position.
The updated Disaster Recovery Plan has significantly reduced the RTO, and CapEx (capital expenses) have been converted to OpEx (operating expenses). The new programs can now be converted from COBOL to C# and .NET on the Azure Platform, positioning the client for growth in the future.
Overall, the client has been able to increase their focus on creating new products instead of spending time maintaining the adjudication system and an on-prem data center. The client has achieved a lightning-fast, cost-effective solution that has positioned them for success in the future.
AMISYS: Empowering Modern Healthcare Systems
AMISYS is a comprehensive healthcare management system designed to streamline administrative and operational processes for health plans and insurance companies. This sophisticated platform offers a range of tools to manage member enrollment, claims processing, billing, and reporting. AMISYS enhances efficiency by integrating multiple functionalities into a single, user-friendly interface, allowing organizations to improve service delivery and compliance with industry standards.
Who Uses AMISYS?
AMISYS is widely adopted by health insurance providers, managed care organizations (MCOs), and third-party administrators (TPAs) to manage complex healthcare transactions. It is an ideal solution for organizations looking to optimize their administrative workflows, reduce operational costs, and improve overall member satisfaction. Health plans across various markets, including commercial, Medicaid, and Medicare, leverage Amisys to ensure seamless healthcare management and superior customer service.
This integration helps these organizations remain competitive in the rapidly evolving healthcare industry by providing scalable solutions that can adapt to changing regulatory requirements and market demands.