Consulting

Get Quality IT Consulting Reasonably and Quickly

  • Expert Data Courier and Chronicles import help during times of heavy workload.
  • Building or updating Interconnect Servers, SOAP proxies
  • Cache System Management help
  • Clarity Administration help – adding tables, fixing duplicate data errors, expanding fields, etc.
  • Detangling Unix issues, problem SQL queries and performance issues.
  • Debug software and make it readable, maintainable, efficient, robust, and performance tested.
  • Move services into Docker and establish a proper migration path from development to test to production.
  • Set up web servers on nginx or apache.
  • Set up WordPress, Drupal, MySQL, Mariadb, or Postgres.
  • Obtain various services such as domain registration, web hosting, VPS or cloud service as appropriate for your needs.
  • Set up postfix email server with MailScanner and Mailwatch, spamassassin, and clamav to protect against viruses and spam.
  • Set up fail2ban on Linux to block spambots and hackers.
  • Install and configure various modules into Drupal or WordPress.
  • Maintain, update, configure Moodle for education sites, Joomla, or Tikiwiki.

Get Setup First!

There is no cost for setting up a connection between your network or systems and mine in order to accomplish work.

Before starting work, I like to meet and discuss needs or requirements and brainstorm out a rough plan first and then begin work with a more thorough brainstorming out of an overall architecture of the work to be done with user stories that would help break the project down into smaller phases or releases.

Brainstorming – The Joy of Project Design

For my own work, I typically take what people call a kanban approach.  Back in the 1990s, I went through PMI (project management) training and professional customer support training in addition to much technical training and education in advanced systems and databases.  Because of that, I can work well with people to break down a project into its components, brainstorm for ideas, organize them, and bring them back together into a well-organized, complete, maintainable, well-designed architecture.

Detangling and Turn-Around Projects

But one skill I have been recognized for in the past was detangling or turn-around consulting.  For instance, one pharmacy benefits management company inherited about $400,000,000 in Medicaid business per year suddenly, but they had been a commercial company and knew almost nothing about Pharmacy Encounters files.  Now they had to provide those in different formats for health plans in several states or face millions of dollars in fines and lost blood products revenue.

A few brilliant and skilled PL/SQL developers created some complicated SQL joins to match claims up with records from other tables–tables for physicians, pharmacies, insurance plans, and such, and they attempted to format the output of that data all in one fell-swoop in the spirit of letting the database calculate the most efficient way to get the data from the database and present it properly.  But the results were disastrous.

Data Gets Hopelessly Scrambled

Unfortunately, the developers would get deluged with competing requests from several health plans.  There were missing physician IDs and missing Pharmacy IDs and claims were being missed.  Some data was incorrectly entered and overran the formats of various fields.  And while the states continued to return error files, there were no mechanisms built to scan in those error files and produce corrections.  Nor was there a way to determine which claims had not been sent.  And what was needed was better error detection, some helpful and reliable data mining for some data that could be properly mined, and a mechanism for sending in claim reversals, waiting for recognition of the reversal and sending in the corrected claim.

Data Gets Unscrambled

Since we could not afford to stop sending in the encounters files, I held weekly meetings with leadership in all of Centene’s subsidiary companies to establish priorities and expectations for the following week.

By the time I left the company, our senior VP said our encounters were second only to one other department, and that department had a very large staff and a very small volume.

During that time, I developed parsing programs to scan the files we had previously sent back into the database to track what we had sent and what errors had been reported back to us.  I split out the massive, ugly SQL joins into separate cursors and functions and designed the encounters program to be more general in nature separating the queries from the presentation of the formatted data.

Filling in Missing Data Accurately

Where claims were missing a physician ID, that was reported and an attempt was made to determine if the claim at hand was for a maintenance medication for which the same prescription had been used.  During the switch from DEA and state Medicaid numbers to NPI numbers, new resident doctors often did not have IDs of their own, so they would submit prescriptions with an institutional DEA number and their own last name.  However, the states had begun to require reporting to be provided with NPI numbers.  So, for a claim with no physician NPI number, I would check the RX number for other claims which indeed had an NPI number corresponding to a physician with the same last name and report on the match so it could be corrected in the database while sending the data through to the state.

We dealt with approximately 68,000 pharmacies, so I also had to develop similar techniques for recovering pharmacy IDs or identifying those which were missing.

For some states, hundreds of thousands of records had been sent through with numbers skewed to the left or to the right causing them to be multiplied or divided by ten, and some had blown the width of the field and had been replaced with pound signs.

Some health plans in some states provided ids by which we could identify the encounter record that was sent.  For others, and New Jersey in particular, to effect a correction, I had to look for information that would uniquely identify the record sent to the state and match that against the error report coming back from the state.  And then I would have to send a reversal.  It would have to be accepted and then the replacement would be sent and accepted in the next encounters run.

Tens of Millions of Dollars Saved

In the end, I believe I helped save the company tens of millions of dollars in lost revenue and fines.  And I had a tremendous amount of fun doing that where other developers left in frustration after about 3 months of struggles and pressure.

I am different.  I enjoy a good, tough challenge.  For me, an impossible challenge is more enjoyable and easier to handle than a boring challenge.

 

Other Non-Epic Skills in Computer Science and Mathematics

Although my focus is Epic technical work, I am also highly experienced and skilled in Unix Administration, database, and web administration, Drupal, WordPress, and am becoming strong with DevOps and  Docker.  I also have a B.A. in Mathematics and a minor in Physics from Fresno State, and 27 units of graduate study in Computer Science at Stanford University with a focus on Advanced Systems and Databases.

Thank you, and have an awesome day!

Daniel J. Dickf


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