Possibilities - The Travelers Insurance Company 3/94

Contact:   eSoft, Inc. (Makers of TBBS)
           15200 E. Girard Ave., Suite 3000
           Aurora, CO  80014
           (303) 699-6565      Voice
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           (303) 699-8222      BBS
           support@esoft.com   E-Mail

THE TRAVELERS INSURANCE COMPANY 3/94
------------------------------------

*** From March 1994 Possibilities Newsletter ***
*** Copyright 1994 by eSoft, Inc.  All Rights Reserved ***

Excitement in software doesn't always come from a flashy interface.  When 
you can replace 30-40 computers and outdated, expensive and inflexible 
mainframe and mini computer communications links with a single PC per 
office, the cost savings can get pretty exciting.

Reeves Westmoreland of The Travelers Insurance Company in Hartford,
Connecticut, did just that when he used TBBS and TDBS to dramatically reduce 
the size, complexity and cost of their electronic claims submission system.
What's more, in the process he's made the system much more usable and 
efficient as he added new capabilities which were not feasible with the 
older, more expensive system.

Westmoreland, Electronic Media Claims Coordinator for Medicare at The 
Travelers' Hartford home office, said the push to get doctors and hospitals 
to submit their claims electronically actually started 8-10 years ago.  
Since then, the microcomputer has come into increasing play, replacing the 
mainframes and mini computers which used to carry the ever-growing load.

The Travelers is a processor of Medicare Part B claims for four states.  The 
company also handles Medicare claims for all retired railroad workers in the 
country.  "We do about 30 million claims a year in our Part B operation," 
Reeves said.  "75% to 80% of these are now electronically submitted.  As 
transmission speeds increase, more of the heavy submitters are moving to the 
BBS because of the speed and the considerably lower equipment cost."

However, this migration -- from claim submissions via peer-to-host 
communications and magnetic tape to submissions via a microcomputer-based 
TBBS online information system -- wasn't without its growing pains.

"We [started out] using a one-line, one-modem, one-PC system to collect 
these claims," Reeves explained.  "We had 30 or 40 different systems, doing 
nothing but collecting claims.  In the home office, we had ten machines 
collecting data from toll-free 1-800 lines.  In each field office (in 
Virginia, Connecticut and Mississippi), we had another pile of machines.  As 
the volume increased, we would just add another PC and modem.  We couldn't 
support anything faster than 2400 baud and we were just getting swamped.  
The people I work for were getting concerned about this proliferation of 
hardware, so we were looking for a technology upgrade.  Instead of forty- 
plus machines all around the country, we needed to have just one PC in each 
office, doing the same thing and more."

The upgrade path Reeves selected was TBBS.  "I have a friend here in 
Connecticut who is a TBBS evangelist," Reeves explained.  "In talking BBSs 
in general, he suggested I should look at the product because of its multi- 
line capability, flexibility, and overall ease of use.  I took his initial 
recommendation and looked at some installations he had running, then talked 
to the eSoft staff in Colorado.  I concluded TBBS would easily handle the 
job.  In addition, it appeared to be a very very stable system.  Rather than 
spending a year investigating everything out there, we decided to give TBBS 
a try."

The change was dramatic -- and immediate.

"With TBBS we've done two things -- we've reduced that pile of PCs down to 
one machine in each field office and we've put both the local lines and the 
toll-free lines into each of the field offices," Reeves said.  "We're also 
now in the process of eliminating the entire group of machines in the 
Connecticut home office, which used to handle only the toll-free lines."

A TBBS system in each of those regional offices is set up with 16 line 
capability.  Reeves said they can now easily add more lines to any of the 
systems as they are needed, a step that's not only easier than adding 
another machine and modem but a lot less expensive.  Each TBBS is set up 
with simple menus which allow file uploads from the various medical clients 
served by the company.  One option on each system's menu allows healthcare 
providers to access an interactive forum to ask questions.  The field 
offices check these message bases every day and leave answers.  An external 
event unzips all the zipped files received on each system every day and 
sends them to the host system at around 4 a.m.

Reeves said installing the TBBS system was simple and straightforward.  "It 
was very easy and one of the things that made it easy is my friend, who has 
been a system operator on a number of TBBS systems here in Connecticut," he 
explained.  "He said, 'before you strike out on your own, why don't you come 
down here and talk to me?'  I took my portable Compaq and one of my TBBS 
packages down there and he went through an initial setup for me -- 
installing it on my portable to show me what's involved and guide me through 
the first installation.  It made a big difference."

Reeves made it clear he could have done it all himself, but his friend made 
the process a lot easier.  "I can't say we wouldn't have completed the 
system without my friend, but it's good advice to seek out someone familiar 
with TBBS, like I did, for help in setting it all up the first time -- 
especially if you hate reading manuals like I do.  It facilitated 
installation to work with somebody who had used the software before.  From 
the time I talked to my friend until I had TBBS up and running back in the 
office -- on a single line, so someone could call in, log on and give it a 
try -- was less than a day, roughly an afternoon."

Reeves also avails himself of eSoft's support BBS (303-699-8222) as a source 
of continuous help and information.  "It's like a large -- and growing -- 
club," he said.  "I found helpful questions posted on the eSoft Support BBS 
and I found you can post a message on the support board and there are always 
plenty of people willing to help out."

As soon as the Travelers' TBBS was installed and running, Reeves started 
hearing from pleased claims submitters.  "They wish we'd done this years 
ago, because of the increased speed and flexibility," he said.  "[With TBBS] 
we accept more formats than we did with the old system and we can talk to 
people now that for years have been mailing in tapes because their volume 
was so large.  Now we give them 9600 baud capability plus we can accept ZIP 
files."

TBBS also makes it easy for The Travelers to deal with future needs.  Reeves 
said Travelers management is pleased with the system's flexibility.  "They 
were very happy to see it come in and, now that it's been up and running a 
while, I get periodic calls from them saying, 'Can the bulletin board do 
this?' 'Can we distribute our durable medical equipment policy using the 
bulletin board?' and the like, and I can answer 'of course it can."

One of those future needs involved the new American National Standard (ANS) 
X.12 claims submission and remittance advice format, X12/837.  This is a 
claims submission format which in the future will be mandated for all 
medical claim submissions as part of the Clinton healthcare plan.  "Then 
there is ANS X12/835, which is an electronic remittance advice format," 
Reeves added.  "It's a very interesting concept for application-to- 
application transactions.  We will be collecting these.  We support them now 
and we will be receiving them through the BBS.  The ease of changing TBBS 
made it a trivial exercise to say we have another format coming in, set up 
another menu selection and flag the people who are going to be sending it 
in.  It took me about ten minutes to set the whole thing up and meet this 
specification.  If we had to use our old system, we'd STILL be working on 
it!"

The new Travelers TBBS installation also met another important industry 
specification from the moment it went online.  The Health Care Financing 
Administration (HCFA), which operates under Social Security Health and Human 
Services, published a requirement that each carrier should, on its own, 
select and set up a bulletin board system.

"They had a list of maybe five or six things, core elements that they wanted 
to see on these BBSs, apart from claims collection -- that didn't even enter 
into it from their standpoint," Reeves said.  "They wanted things like 
monthly newsletters, Medicare bulletins, pricing schedules -- things like 
that -- which would be available to Medicare providers so they could either 
read them or download them.  This is a requirement, NOT just a 
recommendation, for each of the 30-plus Medicare carriers around the 
country.  We were far enough into it already to know what was reasonable 
when they started talking -- what would be an easy thing to do and what 
would be difficult or impossible.  They were very happy to see there were 
some carriers already moving down the BBS path -- and TBBS was easily 
capable of meeting all of their requirements."

The Travelers TBBS system was also immediately able to perform another 
important task -- handling durable medical equipment processing.  "We do 
durable medical equipment processing for the Northeast region and that's 
where the first one of these systems went in," Reeves said.  "We needed 
something we could install very quickly and start collecting both production 
and test files.  This is a new concept in medicine where we, the local 
carrier, handle durable medical equipment claims.  They're all handled by a 
regional office [which covers] an approximately 12-state region.  It was 
nice the way TBBS fell right in there and solved the problem.  We're 
certainly happy with our selection.  TBBS was exactly what we were looking 
for."

Reeves has also expanded the company's arsenal of online information system 
tools with TDBS, the TBBS Option Module that adds xBASE language capability 
to TBBS.

"I ordered TDBS because I like the ability to do things with my data while 
it's online, without having to bring the system down," Reeves said.  "There 
are some very specific applications I plan for it.  For example, balancing 
the claims files when they come in and being able to provide immediate 
feedback to the people sending in the data while they're still online -- 
saying, for example, 'Your file is in balance.'"

Right now, Reeves is using TDBS to run Postmaster, a popular third-party 
TDBS application.  "I use Postmaster to distribute software upgrades and 
other changes we need to get out to our people," he explained.  "With 
Postmaster, I can keep a list of people by, for example, authorization 
flags.  It allows me, if I wish, to maintain a mailing list of everybody who 
has their A2-3 flag turned on.  It then looks at the TBBS userlog and builds 
an address file of all these people.  Then I can send out notices so, when 
those specific users log on, they'll have a memo waiting for them.  I can 
also attach files to these distributed memos.  We use it to send out the 
software used to generate Medicare claims and then send them back to us."

SYSOM, the TBBS Option Module which provides remote access to DOS, is also 
now considered an indispensable tool.  "My mentor here in Connecticut told 
me, whatever I do, get SYSOM, and I'm glad I did," he said.  "I'm on each of 
our boards daily and I do it right from home.  If there's a problem, or 
something needs done -- such as an additional item on a menu -- I do all 
that remotely, too."

Reeves said, in just a few short months, he's not only mastered TBBS, saving 
his company a lot of money and growing headaches -- he's also already acting 
as something of a TBBS mentor himself.  "One member of our Minnesota field 
office staff, who is a computer science major, asked me if he could set up 
TBBS on his own," he explained.  "He looked at some of my SDL files and did 
it, without anyone sitting next to him, and he had no troubles."

It's this kind of experience that instills increased confidence -- moving 
directly from novice to helping others repeat your success.  "It's been 
fun," Reeves said.  "I hate to tell people I'm having fun with TBBS, because 
some of them are liable to get concerned, but it IS enjoyable.  I had been 
involved in PCs for a long time, and with BBSs as a subscriber -- and you 
could just see the writing on the wall, because more and more companies are 
constantly adding BBS numbers to their letterheads and business cards."

Fortunately, Reeves not only saw the writing on the wall -- he READ it and 
ACTED on it, moving The Travelers Insurance Company into the forefront of 
online healthcare processing with TBBS.

PS0394-6
Rev. 3/94

Copyright (C) 1994 eSoft, Inc., All Rights Reserved.  Permission granted
to distribute this file in its entirety, without modification, to any
interested party.  Any other use requires the written permission of
eSoft, Inc.

IMPORTANT:  The information herein is subject to change without notice.
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