Client Profile:

Founded by the Department of Family Practice and Community Health at the University of Minnesota, UCare is an independent, not-for-profit health plan providing healthcare and administrative services to more than 225,000 members in Minnesota and Wisconsin. One of the largest health plans in Minnesota, UCare serves Medicare-eligible individuals, persons enrolled in MinnesotaCare and Medical Assistance programs, and adults with disabilities.

In order to continue to provide the highest quality, award winning care to its program beneficiaries, UCare needed to upgrade their Amisys claims processing systems, including legacy and leading edge platforms, as well as enterprise systems integration.

Solution:

With subject matter expertise in Amisys, Amisys Advance as well as claims processing, membership, eligibility and benefits, authorizations and EDI, Upp Technology healthcare information technology staff onsite at UCare have led conversion and upgrade efforts in the areas of EOB processing for Wisconsin member claims, and in reporting.

Adhering to UCare’s programming standards and policies in an Agile environment, and working to an aggressive timetable, Upp Technology personnel have converted dozens of mission critical applications, from conducting systems analyses and making recommendations to  system design, development, coding, maintenance, testing, and implementation.

In a dual role as business analysts, team members have analyzed business requirements, developed specifications, conducted impact analyses, and created high level and detail application designs – in addition to coding tables, scripts, DDLs, packages, procedures, queries and batch jobs in an Amisys environment on Oracle, also including McKesson CCMS and other third-party systems integration.

Business Value:

As UCare’s continues to grow in size, membership, and geographic coverage, upgrading Amisys with the help of Upp Technology knowledge and experience in healthcare claims processing and other information technology systems will enable UCare to reduce labor-intensive processing, yielding increased productivity, efficiencies and cost savings to the benefit of the organization and its customers.

Innovative Technology Solutions