Thanks, all - these are all great suggestions, and I'm going to start looking into everything!
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Thanks, all - these are all great suggestions, and I'm going to start looking into everything!
OK, so let's assume 25,000 transactions per day (trickling in, not in batch) - what kind of (hardware) database server should I be looking at?
Sorry Neg~ I really am not making a good job of this one:(
OK, we have 25,000 transactions per day. I would guess that to be 8 hours, although you might get a bit more mileage if you cross time zones (see? typical bloody European, I forgot to ask that:D)
That covers the intake of claims, but what is the claims processing mechanism and its requirements? I am guessing that when you accept the initial entry, you validate that the policy exists, is current and that the item is covered?
All that you need then is to update the payment process record? Whilst actual payments will be in your finance system (I would imagine?) you still need an interface to generate a record of the indebtedness. That I would suspect could be run as a batch job?
I am afraid that I really need to get a grip on the degree of integration and segregation here? Like will you have all the policy data on the claims database?............... what I am asking is just what data do we need this server or servers to handle?
Also, am I correct in assuming that the reimbursements will go to the service and goods providers rather than the patients?......yes, I would siphon that through accounts payable, but I need to interface and create a record?
Right now I am looking at a single server with 4 Xeon equivalents and maybe 6 SCSI drives.................
I am assuming a third normal form, or maybe 2.5 normal form database? and not a lot of metadata?
Basically your policy data is just a glorified lookup table that you update in batch overnight? That is the bulk of your data holding, but is relatively static?
BTW we need to talk a bit more on reporting and internal audit reports;)
Given that this site is open, you may want to PM me, as I do not know if this exercise is competitive or not?............... actually they usually are, because you take the best answers and mark down from them?
Please pass my regards to Mel, thanks
Johnno
Yes, all policy data would be on the same database, and reimbursements go to the health provider. Third normal form, no metadata. Anything outside of the claims process (such as reporting and internal audit reports), we can ignore :)
So, a single server (Windows Server 2008, SQL Server?) could run this thing without too much trouble?