Despite having to deal with legacy applications for claims processing, health insurer HBA has taken a leading position with open information interchange in line with the Health Insurance Commission's (HIC) specifications, according to CIO Peter Powell.
After separating from AXA three years ago, HBA has established its own core backend system and successfully migrated it from a mainframe to Oracle on Sun.
In parallel with that transformation, Powell said HBA has taken a leading position developing software for HIC's Eclipse project which will allow better access to data between hospitals and insurers.
"We worked with HIC to do the first round of testing [which] covered claims submitted by providers and enquiries to validate the member," Powell said, adding that since Eclipse went live in 2004, HBA has processed 45 percent of all claims made through HIC.
With the legacy system in place, Powell said HBA had to create transactions as "pseudo services" - not exactly Web services but a mixture of synchronous and asynchronous services.
Eclipse promises to reduce processing time and the amount of effort to key claims into systems as a lot still come in via fax.
"This opens it up and enables everyone to deal electronically," Powell said. "Online patient verification is instantaneous at the hospital and a lot of that is manual at the moment. It will be in real time."
Powell described Eclipse as being of "tremendous benefit" to the overall industry, and once everyone is on it "the real value comes out".
Since HBA is still hooking into Cobol, it is using Microfocus to develop the modern applications with a view to Web services for linking them to a .Net-based customer front-end.
HBA chose to develop its Web applications in .Net because of its history or Visual Basic development, the "richer" development tools, and with a view to getting applications into a common architecture so components can be reused.
HBA expects its member base to reach one million members nationally, and having opened a retail presence in NSW late last year, the insurer anticipates the new front-end will be a platform to decrease its time to market with new offers.
This is a new project which is slated for completion in Q3 this year.
"We will deploy .Net internally and can then reuse it to deploy it across the Internet," Powell said. "The front-end will be used in call centres and retail outlets [thus] creating a platform where we can decrease time to market."