Swiss Medical Group Selects ILog JRules to Streamline Claims ... (centrally maintaining and managingthe bu...)

Swiss Medical Group Selects ILog JRules to Streamline Claims Processing

Date:9/30/2008

centrally maintaining and managing the business rules with the utmost of transparency have made a significant impact on improving efficiency. With the previous system, conspiracy to defraud between medical students, practitioners, patients and internal personnel was problematic and difficult to control. Today, deception is avoided by electronically processing claims using ILOG JRules and avoiding long-standing contracts between the claims processor and the practitioner.

Prior to automating the system, fraudulent claims were not easily identified; this resulted in payment for procedures not covered under the government's healthcare plan. Today, false claims are detected with ILOG JRules and are efficiently processed by determining what percentage of each procedure is covered by the government and which portion can be paid for by the Swiss Medical Group plan.

ILOG has consistently built on its history of product innovation to make it one of the industry's leading providers of business rule management systems (BRMS). Forrester Research has recognized ILOG as a resounding leader in Business rules platforms, including the sole leader in rules platforms for .NET, a leader in business rule platforms for Java, for business analysts and for overall feature sets. Customers of ILOG's award-winning BRMS products include eBay, Equifax, Grupo Santander, Travelocity, Visa and many other leading Global 2000 companies and governments worldwide. ILOG's BRMS product line includes ILOG JRules(R), ILOG Rules for .NET(R) and ILOG Rules for Cobol(R) To learn more about ILOG's BRMS products, please visit http://www.ilog.com/products/businessrules.

About ILOG

ILOG delivers software and services that empower customers to make better decisions faster and manage change and complexity. Over 3,000 corporations and more than 465 leading software vendors rely on ILOG's market-leading business rule ma
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