In addition to medical underwriting expertise, Blue Ridge Software has extensive
experience in other rules-based design and development. Blue Ridge consultants
have worked with dozens of customers in application areas such as P&C
underwriting (auto, home, boat, fire), risk management, financial applications such
as loan approval, and manufacturing systems specializing in complex scheduling.
From the definition of requirements through system testing, Blue Ridge Software
can help your business solve real-world problems using the time-tested techniques
of rules-based development…

Healthcare Claims Evaluation

From years of implementing medical underwriting systems, Blue Ridge has
discovered that one of the main reasons for doing medical underwriting instead of
statistical analysis is to gauge on the health risk of a group or block of business.  
Underwriting is a process of looking at each individual member - from claims to
procedures to medications - in such a detailed way to attach a health risk factor.  
The health risk factor could be for establishing a renewal rate or just to compare
since the last renewal rate was issued.  Using pooled claim dollars for a group or
assigning risk based solely on the presence of a medical condition is not nearly as
comprehensive.   Claim dollars can be a useful factor, but often a person is healthy
again after a costly procedure or course of treatment.  Using certain factors about a
medical condition, underwriting can more predictive by assigning risk before the
claims show up.  

Blue Ridge can determine the relative health risk of any segment from individuals to
large groups.  While not necessarily used to set rate levels, the data is very useful as
a snapshot.  Several snapshots on a quarterly or semi-annually basis show the
health trends of the block.

Blue Ridge looks at as few as 6 fields from claims & drugs, or as many as 14.  One
time or recurring evaluations can be done on-site or off-site depending on data
limitations.   Email claimsevaluation@blueridgesoftware.com for more details...

Computer Associates Cleverpath Aion BRE Consulting

Aion is a leading tool for rules-based development.  Blue Ridge consultants have
been using Aion since the 1980s, when "Artificial Intelligence" was the catch
phrase.  Buzz words like "AI" & "OO" may come and go, but Blue Ridge's solid
Aion methodology has evolved as new techniques for component deployment have
emerged.

Blue Ridge is up-to-date on the latest trends of end-user rule maintenance using
Aion and other tools.  Business experts want to manage their own domain, but
frequently they can't because of technical barriers that IT must resolve.  Mark
Traub, president of Blue Ridge Software, has presented three times at CA World
on evolving techniques for end-user rule maintenance.  Blue Ridge has
demonstrated (and is selling) Aion software that generates Aion rule libraries start
to finish from a user-friendly interface.  

Moreover, Blue Ridge's methodology for Aion conversions from 6.5/7.0 is a
proven winner.  There are six (6) basic steps:

  *  Gauge the application structure and complexity using CA's ORCA tool that comes
with Aion.
  *  Extract the old Aion object model and establish a new Aion class structure.  This
can be done with a variety of tools.
  *  Extract the old Aion data model (and SQL) into new Aion hierarchical Query Classes.
  *  Convert and clean up old Aion methods, functions, vocabularies, & states into new
Aion classes and attributes.
  *  Convert rules into new Aion rule classes and rules using updated Object Model.
  *  Clean up and test.

Aion conversions should not take years - call Blue Ridge Software for an
assessment!