1. Captures... each encounter's demographic, insurance, and clinical data--as defined by the facility (e.g., payors, planned procedures).
2. Identifies...specific rules that apply to this encounter (e.g., a certification requirement that results from the patient being in a particular Blue Cross group).
3. Notifies...the patient and/or facility personnel of important information related to the rule (e.g., a notice is printed for a Medicare patient with non-covered services).
4. Confirms...to help assure that tasks related to the matched rules are completed (e.g., the required certification number is obtained and recorded).

RulePro^® first captures data for a particular patient encounter. The type and number of data elements that are captured are specified by each user-facility. Many of these data elements (e.g., diagnostic and procedure codes) have facility-specific look-up tables. RulePro^® edits and cross-edits data to assure validity. Users can also enter "free text" information related to each patient encounter.

Once the data for a particular encounter are complete, RulePro^® compares these data against a set of facility-specific rules to identify "matched rules" that apply to the patient encounter, and displays these matched rules to the user. The matched rules usually have associated "actions" that must be completed for the rule to be met (e.g., obtain a certification number). If possible, the user performs the action(s) and enters the associated data value(s) (e.g., the certification number) into RulePro^®. If the action cannot be performed at this time, the RulePro^® control capability will remind the user of the unmet rule(s) via an on-demand reporting and can provide online work queues. The user can also enter free-text related to each rule (e.g., the actions that were followed in completing the rule).

Matched rules can also have associated "print forms" (notices), that can be printed and given to the patient (e.g., a form notifying the patient of a non-covered service) or used by facility personnel (e.g., a case management worksheet that contains patient-specific data contained within RulePro^®).

Records of all patient encounters, along with the associated rule information and user-entered text, are stored in the RulePro^® database for later completion, update, review, and report generation. RulePro^® allows the user to print on-demand two standard reports--the "Unmet Rules Report" (that helps assure that all rules are completed fully and in a timely manner) and the "Data Error Report" (that helps assure that all required data are obtained and are valid).

RulePro^® adds effectiveness and efficiency to your patient care support processes, quickly identifying patients for whom various activities should be performed.

RulePro^® delivers this effectiveness and efficiency through a powerful, yet easy to use, rule builder. This rule builder provides the best tool available to write, edit, and save your organization's rules, associated actions, and associated print forms (notices). The rule builder puts you in control of both the software and your processes.

RulePro^® is multi-user, and can, by appropriate platform selection, be scaled-up to handle many users.

RulePro^® also includes user-defined templates that can be used to capture structured supplemental data within free text areas, standard reports oriented to assuring control of patient care support processes, and an ODBC-compliant database that can be used by your facility to generate additional internal reports.

RulePro^® was designed to function as a stand-alone or interfaced system. Huron has developed interfaces to a number of registration, patient appointment and surgery systems. A custom interface to RulePro^® can be built in any user facility that decides one is required. Whether an interface is required is usually determined by i) the number of data elements that a facility decides to include in RulePro^®; and ii) the existence of procedures to assure that all patient encounters of interest are entered into RulePro^®.

RulePro^® substantially improves the efficiency of handling patient care support activities, helping to assure that these tasks are completed in a timely and accurate manner. It is virtually impossible for healthcare personnel to remember, let alone follow, all of the rules that apply to today's complex environment. RulePro^® provides order and control to pre-service activities--an area of ever-increasing importance.

RulePro^® enhances revenues by helping healthcare facilities assure that all activities that must be performed to enable full reimbursement are known and completed.

RulePro^® improves physician satisfaction by prospectively identifying certification requirements and non-covered service situations. This reduces physician and staff time spent on the phone with managed care companies as well as spent addressing insurance and managed care denials.

RulePro^® improves patient satisfaction by identifying, in advance, the financial and clinical support requirements necessary for their care.

RulePro^® utilizes a client/server architecture that consists of:

• Client applications, written in Visual Basic and running under Windows 98/XP/Vista/2000/2003.
• Application Services (e.g., Rules), written in Visual C++ and running under Windows 2000/2003 Server.
• Interface Services, as needed, written in Visual C++ and running under Windows 2000/2003 Server.
• A Microsoft SQL Server DBMS.

RulePro^® has three deployment options:

1. Traditional Client/Server.
2. Internally Hosted Terminal Services (Thin Client).
3. Application Service Provider (Externally Hosted Thin Client).

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