Healthcare Billing platform

About the product:
A coding and billing platform for a small to medium size hospitals, present across the United States and United Kingdom.

Why build this product?

1. Be able to communicate with interfaces of different insurance companies.
2. Be able to address differences in language, business rules, coding and billing standards based on the hospital/country
3. Fast and robust application, with ability to deal with huge pools of data.
4. Be build quickly and inexpensively
5. Must have a competitive edge over existing solutions with regards to price, reliability and functionality.

Options available:

1. Design and develop the system using traditionally waterfall model
2. Design and develop the system using Agile
3. Design the system and outsource chunks of works to 2-3 medium sized service providers

Why choose agile

1. Function and test driven development – same project using waterfall methodology would have taken at least 120 weeks to complete.
2. Value for money : Providing cost-effective solutions by adhering to deadlines
3. Adaptive solutions : Keeping pace with rapidly changing business models and operations,
4. High quality software in least possible time duration and satisfied customer.

Project benchmarks
Time line
Expected: 36 weeks, Actual :38 weeks
No of sprints: 18

Team
1 Product Owner
1 Deliver manager
4 Developers and 1 QA
8 specialist coding and billing users

Technology
.Net Framework 2, C# with Winforms, Webforms, SQL Server, COM+, Soap webservices and 3rd party controls.
Nunit, CruiseControl, FxCop, StyleCop, Profiler and Reflector.
3 integrations with insurance interfaces
3 integrations with PAS
2 integrations with PAX
8 integrations with coding, billing encoders and tools.

Agile approach

1. Adaptive development, able to respond to the ever changing requirements.
2. The documentation is crisp and to the point to save time.
3. The team does not have to invest time and effort and finally find that by the time they delivered the product, the requirement of the customer has changed.
4. Face to face communication and continuous inputs from customer representative leaves no space for guesswork.

Results

1. Robust, scalable and distributed enterprise software
2. Flexible reporting and dashboards
3. Built-in server performance monitors and health checks.
4. Smooth transition from project to product

Achievements:

1. User base of 400 coders and billers with a centralized data server
2. An average of 1000 charts coded and billed per day per hospital
3. Extremely fast solution, given the fact that the system has millions of patient, coding and billing data imported from legacy systems.
4. Deployed at 3 major hospitals in US.
5. 99.9% availability as per SLA and past data
6. Functionality delivered with less cost & faster than competitive solutions

Success Criteria
Planning should be on ongoing evaluation and adjustment process, not mere preparation of a deliverable
Bi-weekly releases and concurrent UAT eliminates ll operational issues well before time.
Proper use of software, like Nunit, CruiseControl, FxCop, StyleCop etc in sync with the development methodology goes a     long way in simplifying common development related issues.