Project Management to Upgrade and Enhance Billing Software and Infrastructure in a Complex Environment

Client Description

The client is a large, geographically diverse health and human services agency, offering Human Services and Post-Acute Specialty Rehabilitation Services to individuals in thirty-six states.


The client wanted to upgrade its billing applications to a more advanced and ICD-10 compliant version of the software. The client’s operational and financial organization was decentralized, with hubs of accountability within each state where they provide services as well as a centralized billing office that supports some, but not all activity. The client uses a combination of third party and homegrown software and has a highly complex architecture. ICD-10 compliance is an organizational challenge as well as a technical one for this client given all of the stakeholders, service lines, and solutions that are in place. A significant infrastructure migration was also required as a precursor to the software upgrade. Overall, the project spanned locations in 16 states and affected more than 1,600 users and multiple data centers.


The technical solution included replacements of multiple servers and moves across multiple data centers. In addition, as a result of the server migration, additional features, like journaling and shadowing, were available to assist with overall data management. The software solutions included in the scope of the software upgrade were Registration, Authorizations, Electronic Health Records/Clinical, Billing and Accounts Receivable, Reporting, and EDI along with key integration points with other applications in use in the organization.

Ninestone’s Approach

Ninestone was brought in to manage the full scope of ICD-10 compliance for the organization including operational, financial, and technical challenges because of its rigorous project management approach as well as experience with infrastructure projects and implementing and testing healthcare billing solutions. A comprehensive technical infrastructure plan was developed and executed. In addition, an upgrade and ICD-10 migration plan was developed for each state/service line. The software upgrade involved extensive testing cycles to ensure that the new features — as well as existing reports and customizations, such as interfaces and extracts that add value to the client — remained functional post-technical migration and post upgrade.​


Ninestone worked with the client to define the scope of the infrastructure and software upgrades and the scope of the ICD-10 transition impact. After developing a comprehensive project timeline, we managed the project to an on time, on budget conclusion to ensure that the enterprise was ready for the ICD-10 transition in October, 2015.​