Delta Dental of New Jersey Goes Live with DSI Insurance Claims and Benefits System

(Cork, Ireland) October 1 2007 - DeCare Systems Ireland Ltd, a leading software development and Internet solutions provider, today announced the implementation of a substantial Insurance Claims and Benefits system for US dental coverage provider, Delta Dental of New Jersey. The provider is a leading dental benefits administrator with more than 35 years of claims and benefit management experience, providing coverage to more than 2,000 groups, 1.7 million members, and 12,000 dentists on the east coast.

The .Net based application is a state-of-the-art claims management system built to support all aspects of claims processing; customer service; group, plan, and eligibility management, as well as interface information to external systems. Replacing a number of legacy mainframe applications, the system's design is focused on getting the most efficiency possible: high drop to pay, real-time claims processing, customer service queries, payment, and billing.

The provider’s decision to customise an existing DSI-built dental insurance application implemented for another leading Delta Dental Plan Association (DDPA), member meant concerns about scalability and large volume batch processing were minimised. The project entailed identifying the functionality gaps and implementing client specific code to meet the gaps. Taking just under 16 months to complete, the fully Web-based claims system is built around HIPAA regulations for the US insurer.

Today, this system connects to the provider's Internet site, the Delta Dental Plan Association Portal, and the IVR.

Key Components of the application include:

• Entity Management System to maintain Group, Member, Benefits and Financial information.
• Real-time Claims Adjudication system
• Efficient Provider and Fee Maintenance System
• Electronic Eligibility system to maintain reliable eligibility information.
• Billing and Payment systems which easily interface with third party tool sets.
• Comprehensive Reporting facilities for operational staff and senior management.
• A suite of Web Services that integrate with both Customer Service and external third-party applications.

DSI's relationship with the insurer grew out of a strategic decision to develop a platform that would enable greater efficiency and speed to market. The scalable, rules driven technology platform will also help the DDPA member position itself for future growth. DSI currently builds similar systems for both the DDPA itself and four of it’s member companies.

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