Welcome!

AJAX & REA Authors: Gary Kaiser, Kevin Benedict, Matthew Lobas, RealWire News Distribution, Roger Strukhoff

News Feed Item

Argus Announces Next Generation Pharmacy Claims Processing Solution

Argus delivers RxNova™; flexible, configurable, extensible, auditable, reliable, scalable and intuitively usable

KANSAS CITY, Mo., Nov. 28, 2012 /PRNewswire/ -- Argus Health Systems, Inc., a leading transparent pharmacy benefits administrator, today announced its next-generation claims processing engine, RxNova™. 

From 2011 through 2020, the Centers for Medicare and Medicaid Services projects an 86% increase in prescription drug spending. Also, as predicted by the Affordable Care Act, the number of insured Americans could rise by as many as 33 million over the next decade. This changing market, along with new Health Care Reform regulations and broader coverage requirements, means that health plans must have increasingly flexible tools with comprehensive capabilities to support increasingly complex, customized benefit designs. In this time of rapid market change, health plans must accelerate their product development and personalize benefit designs to satisfy today's members and tomorrow's prospective members. Successful pharmacy benefit administration and management companies must be prepared with advanced technology, significant flexibility and rapid time-to-market solutions to enable their customers to adapt to changing member demographics, external demands, and expected outcomes.

RxNova™ is a technology- and business-driven initiative that began when the company made the strategic decision to invest in our already reliable, functionally-rich claims processing system. This investment to enhance the user experience was a multi-year project to transform the underlying architecture, business design and rules structure of our claims processing technology to create a best-in-breed, highly flexible, highly extensible, easy-to-use, web-based benefit management solution.  The culmination of this effort is RxNova™, the convergence of our customer collaboration and insight with Argus innovation and delivery.  

"Argus has embraced a 'listen first, then act' approach in its system enhancement efforts, ensuring that the resources devoted to this effort have been focused on solving real-world customer issues as opposed to producing technologies in search of a business need, as sometimes happens when companies eschew listening to their customers," stated Mary Ellen Mitchell, COO, Excelsior Solutions, LLC, a pharmaceutical and healthcare consulting firm. "The fact that such material amounts of innovation have occurred without sacrificing the quality of the core service delivery to customers is a testimony to the technical sophistication of Argus."

RxNova™ provides Argus customers with a robust system designed to allow the user to control benefit development through an intuitive protocol that gives the user increased control of their benefit design and exposure to their data without the need for hard coding. This initiative includes a user interface with an intuitive rules-based architecture to engage with the software, delivering greater ease of use, and flexibility in customized benefit design.

To facilitate increased benefit complexities, enhancements to the benefit auditability include customized messaging and tagging options within the benefit rules structure. Embedded into this component is Benefit Validator™, documentation and analytics that provide a real-time accountability trail and audit feature that supports and augments evidence of coverage at the pharmacy-benefit level. Enhancements to claim inquiry include detailed data enrichment that provides a decision flow of the adjudicated claim, including each of the decision points or rules utilized during the adjudication process. The increased visibility into these decision points includes a historical audit perspective that identifies messages associated with the claim as it was adjudicated, such as error exceptions and overrides. Historically, several hours could be spent on pharmacy claim research to determine why and how a particular claim derived its resultant financial and clinical outcome; RxNova™ has built-in data enrichment capability that provides the user a logical view of the executed rules and illuminates the entire picture of the adjudication process from beginning to end.

"Increasing market complexities in the healthcare industry, combined with stringent government regulations and guidance, have compelled businesses that support healthcare to significantly expand their functionality to harness the possibilities created by these trends," said Jonathan Boehm, president and CEO, Argus Health Systems. "Our focus has always been on our customers and offering them the most efficient solutions to meet their business needs. RxNova™ is a culmination of the synergistic relationship we are fortunate to enjoy with our customers. We have integrated new functionality, design flexibility, and powerful rules configuration with robust, reliable and resilient technical infrastructure that allows our customers to confidently deliver their benefit designs in an online fashion, presenting clear visibility into their outcomes based on their business and clinical decisions. We have accomplished this without sacrificing the reliability and scalability they have come to expect with Argus. RxNova™ provides superior navigation, testing, analytic and reporting capabilities, and enables customization at a very granular level. These enhancements also allow our customers to be more competitive related to time to market, help them increase efficiencies, and enable them to take advantage of an integrated claims-benefit management solution. This is an exciting time to be an Argus customer as we continue to focus on our customers and their business demands in this period of rapid change and opportunity."

About Argus Health Systems, Inc.
Argus is a leading independent provider of healthcare information management services supporting commercial, Medicaid and Medicare Part D with a business model that provides full disclosure and transparency. Argus serves a wide range of clients and key healthcare organizations, including managed care organizations, pharmacy benefit managers and pharmaceutical manufacturers. Argus is a wholly-owned subsidiary of DST Systems, Inc. For more information, please visit http://argushealth.com.

About DST Systems, Inc.

DST Systems, Inc. provides sophisticated information processing solutions and services to support the global asset management, insurance, retirement, brokerage, and healthcare industries. In addition to technology products and services, DST also provides integrated print and electronic statement and billing solutions through DST Output. DST's world-class data centers provide technology infrastructure support for financial services and healthcare companies around the globe. Headquartered in Kansas City, MO., DST is a publicly traded company on the New York Stock Exchange.

MEDIA CONTACT:
Larry Stephenson
816-843-9087

The information and comments in this press release may include forward-looking statements respecting DST and its businesses. Such information and comments are based on DST's views as of today, and actual actions or results could differ. There could be a number of factors, risks, uncertainties or contingencies that could affect future actions or results, including but not limited to those set forth in DST's periodic reports (Forms 10-K or 10-Q) filed from time to time with the Securities and Exchange Commission. All such factors should be considered in evaluating any forward-looking statements. The Company undertakes no obligation to update any forward-looking statements in this press release to reflect future events. Brand, service or product names or marks in this press release are trademarks or service marks, registered or otherwise, of DST Systems, Inc., DST subsidiaries or affiliates, or third parties.

The information and comments above may include forward-looking statements respecting DST and its businesses. Such information and comments are based on DST's views as of today, and actual actions or results could differ. There could be a number of factors affecting future actions or results, including those set forth in DST's latest periodic financial report (Form 10-K or 10-Q) filed with the Securities and Exchange Commission. All such factors should be considered in evaluating any forward-looking comment. The Company will not update any forward-looking statements in this press release to reflect future events.

SOURCE Argus Health Systems, Inc.

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Cloud Expo Breaking News
After a couple of false starts, cloud-based desktop solutions are picking up steam, driven by trends such as BYOD and pervasive high-speed connectivity. In his session at 15th Cloud Expo, Seth Bostock, CEO of IndependenceIT, cuts through the hype and the acronyms, and discusses the emergence of full-featured cloud workspaces that do for the desktop what cloud infrastructure did for the server. He’ll discuss VDI vs DaaS, implementation strategies and evaluation criteria.
Cloud computing started a technology revolution; now DevOps is driving that revolution forward. By enabling new approaches to service delivery, cloud and DevOps together are delivering even greater speed, agility, and efficiency. No wonder leading innovators are adopting DevOps and cloud together! In his session at DevOps Summit, Andi Mann, Vice President of Strategic Solutions at CA Technologies, will explore the synergies in these two approaches, with practical tips, techniques, research data, war stories, case studies, and recommendations.
Cloud Computing is evolving into a Big Three of Amazon Web Services, Google Cloud, and Microsoft Azure. Cloud 360: Multi-Cloud Bootcamp, being held Nov 4–5, 2014, in conjunction with 15th Cloud Expo in Santa Clara, CA, delivers a real-world demonstration of how to deploy and configure a scalable and available web application on all three platforms. The Cloud 360 Bootcamp, led by Janakiram MSV, an analyst with Gigaom Research, is the first bootcamp that introduces the core concepts of Infrastructure as a Service (IaaS) based on the workings of the Big Three platforms – Amazon EC2, Google Compute Engine, and Azure VMs. Bootcamp attendees will get to see the big picture and also receive the knowledge needed to make the best cloud decisions for their business applications and entire enterprise IT organization.
Scott Jenson leads a project called The Physical Web within the Chrome team at Google. Project members are working to take the scalability and openness of the web and use it to talk to the exponentially exploding range of smart devices. Nearly every company today working on the IoT comes up with the same basic solution: use my server and you'll be fine. But if we really believe there will be trillions of these devices, that just can't scale. We need a system that is open a scalable and by using the URL as a basic building block, we open this up and get the same resilience that the web enjoys.
The Internet of Things is a natural complement to the cloud and related technologies such as Big Data, analytics, and mobility. In his session at Internet of @ThingsExpo, Joe Weinman will lay out four generic strategies – digital disciplines – to exploit emerging digital technologies for strategic advantage. Joe Weinman has held executive leadership positions at Bell Labs, AT&T, Hewlett-Packard, and Telx, in areas such as corporate strategy, business development, product management, operations, and R&D.
SYS-CON Events announced today that DevOps.com has been named “Media Sponsor” of SYS-CON's “DevOps Summit at Cloud Expo,” which will take place on June 10–12, 2014, at the Javits Center in New York City, New York. DevOps.com is where the world meets DevOps. It is the largest collection of original content relating to DevOps on the web today Featuring up-to-the-minute news, feature stories, blogs, bylined articles and more, DevOps.com is where the thought leaders of the DevOps movement make their ideas known.
There are 182 billion emails sent every day, generating a lot of data about how recipients and ISPs respond. Many marketers take a more-is-better approach to stats, preferring to have the ability to slice and dice their email lists based numerous arbitrary stats. However, fundamentally what really matters is whether or not sending an email to a particular recipient will generate value. Data Scientists can design high-level insights such as engagement prediction models and content clusters that allow marketers to cut through the noise and design their campaigns around strong, predictive signals, rather than arbitrary statistics. SendGrid sends up to half a billion emails a day for customers such as Pinterest and GitHub. All this email adds up to more text than produced in the entire twitterverse. We track events like clicks, opens and deliveries to help improve deliverability for our customers – adding up to over 50 billion useful events every month. While SendGrid data covers only abo...
SYS-CON Events announced today that the Web Host Industry Review has been named “Media Sponsor” of SYS-CON's 15th International Cloud Expo®, which will take place on November 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA. Since 2000, The Web Host Industry Review has made a name for itself as the foremost authority of the Web hosting industry providing reliable, insightful and comprehensive news, reviews and resources to the hosting community. TheWHIR Blogs provides a community of expert industry perspectives. The Web Host Industry Review Magazine also offers a business-minded, issue-driven perspective of interest to executives and decision-makers. WHIR TV offers on demand web hosting video interviews and web hosting video features of the key persons and events of the web hosting industry. WHIR Events brings together like-minded hosting industry professionals and decision-makers in local communities. TheWHIR is an iNET Interactive property.
SYS-CON Events announced today that O'Reilly Media has been named “Media Sponsor” of SYS-CON's 15th International Cloud Expo®, which will take place on November 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA. O'Reilly Media spreads the knowledge of innovators through its books, online services, magazines, and conferences. Since 1978, O'Reilly Media has been a chronicler and catalyst of cutting-edge development, homing in on the technology trends that really matter and spurring their adoption by amplifying "faint signals" from the alpha geeks who are creating the future. An active participant in the technology community, the company has a long history of advocacy, meme-making, and evangelism.
SYS-CON Events announced today that Verizon has been named “Gold Sponsor” of SYS-CON's 15th International Cloud Expo®, which will take place on November 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA. Verizon Enterprise Solutions creates global connections that generate growth, drive business innovation and move society forward. With industry-specific solutions and a full range of global wholesale offerings provided over the company's secure mobility, cloud, strategic networking and advanced communications platforms, Verizon Enterprise Solutions helps open new opportunities around the world for innovation, investment and business transformation. Visit verizonenterprise.com to learn more.
SYS-CON Events announced today that TMCnet has been named “Media Sponsor” of SYS-CON's 15th International Cloud Expo®, which will take place on November 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA. Technology Marketing Corporation (TMC) is the world's leading business to business and integrated marketing media company, servicing niche markets within the communications and technology industries.
"In my session I spoke about enterprise cloud analytics and how we can leverage analytics as a service," explained Ajay Budhraja, CTO at the Department of Justice, in this SYS-CON.tv interview at the 14th International Cloud Expo®, held June 10-12, 2014, at the Javits Center in New York City. Cloud Expo® 2014 Silicon Valley, November 4–6, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading Cloud industry players in the world.
“We are starting to see people move beyond the commodity cloud and enterprises need to start focusing on additional value added services in order to really drive their adoption," explained Jason Mondanaro, Director of Product Management at MetraTech, in this SYS-CON.tv interview at the 14th International Cloud Expo®, held June 10-12, 2014, at the Javits Center in New York City. Cloud Expo® 2014 Silicon Valley, November 4–6, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading Cloud industry players in the world.
"We are automated capacity control software, which basically looks at all the supply and demand and running a virtual cloud environment and does a deep analysis of that and says where should things go," explained Andrew Hillier, Co-founder & CTO of CiRBA, in this SYS-CON.tv interview at the 14th International Cloud Expo®, held June 10-12, 2014, at the Javits Center in New York City. Cloud Expo® 2014 Silicon Valley, November 4–6, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading Cloud industry players in the world.
Almost everyone sees the potential of Internet of Things but how can businesses truly unlock that potential. The key will be in the ability to discover business insight in the midst of an ocean of Big Data generated from billions of embedded devices via Systems of Discover. Businesses will also need to ensure that they can sustain that insight by leveraging the cloud for global reach, scale and elasticity. In his session at Internet of @ThingsExpo, Mac Devine, Distinguished Engineer at IBM, will discuss bringing these three elements together via Systems of Discover.