Resource Logic Client/Server Development Services

Project - Medical Billing and Accounts Receivable


Much of the mid-1980's was spent maintaining and upgrading a medical billing and accounts receivable system for a back-injury and sports medicine clinic. This system was used to schedule appointments, record charges, and bill those charges on a number of standard forms, which were Insurance, Workman's Comp, Medicare, and Private Pay, respectively. Much of the 'Private Pay' was handled by attorneys, who represented clients in lawsuits over automobile accidents.

This system was written in Datapoint Databus. The operational environment when I arrived (circa 1985) was basically paralysis: the system would crash at the end of the month when the bills were being sent out. The recovery consisted of reindexing the files and running a few other administrative processes, none of which could be described as a long term fix.

On the programming front, it turned out there were relatively few issues, although it was necessary to rewrite one report due to changes in Medicare billing. The "unfinished business" such as it was, had to do with how partial payments were accounted for. Most of the work was either demand reports, hardware upgrades (desperately needed), and changes in operational procedures.

Datapoint products had been relatively free of competition, however the PC and Macintosh products were giving all proprietary system vendors a run for their money. Ex-Datapoint executives started a company to make servers based on the PC platform; these were faster and cheaper than anything Datapoint made at the time. One of the chronic problems of the existing system is that it ran out of space: the disks were 60 MB but had 12.5 MB partitions. Space management had become a critical concern.

Using the new server, we simply installed two 120 Mb drives instead of three 60Mb drives. Partition sizes did not change, but the critical files could have exclusive space. The PCs response time was double to triple that of the Datapoint server. In conjunction with this, we dedicated a person to running backups overnight; this was another matter that had not been taken very seriously.

One of the transcription clerks had listened in to the developers as they went about their system design; I was able to train this person in programming and she was able to pick up much of the day to day support responsibility. I was then able to focus on migrating the entire system to the PC platform, which occurred in fits and starts over time. Eventually this proved (as of 1986) to be premature. Management eventually migrated to an AS/400 based replacement. In retrospect, a migration of that system to PCs should not have been attempted until 32-bit versions of Visual Basic were available, which would have been in the 1995 to 1998 timeframe.