ENTERPRISE-SCALE TRANSACTION PROCESSING SOFTWARE WITH ASSOCIATED SOFTWARE CREATION AND EDITING TOOLS FOR THE REAL-TIME PROCESSING OF HIGH VOLUME, INFORMATION-RICH TRANSACTIONS GOVERNED BY CONTRACTS AND RULES THAT HAVE BEEN CONVERTED TO A NATURAL LANGUAGE-LIKE CODE THAT CAN BE DIRECTLY INTERPRETED BY THE TRANSACTION PROCESSING SOFTWARE WITHIN THE CONTEXT OF CURRENT AND HISTORICAL DATA AS MAINTAINED IN A REAL AND NEAR-REAL TIME DATA WAREHOUSE

PROVIDING COMPREHENSIVE SERVICES TO BUSINESS CUSTOMERS BASED ON USING ENTERPRISE-SCALE TRANSACTION PROCESSING SOFTWARE AND ITS ASSOCIATED SOFTWARE CREATION AND EDITING TOOLS FOR THE REAL-TIME PROCESSING OF HIGH VOLUME, INFORMATION-RICH TRANSACTIONS GOVERNED BY CONTRACTS AND RULES THAT HAVE BEEN CONVERTED TO A NATURAL LANGUAGE-LIKE CODE THAT CAN BE DIRECTLY INTERPRETED BY THE TRANSACTION PROCESSING SOFTWARE WITHIN THE CONTEXT OF CURRENT AND HISTORICAL DATA AS MAINTAINED IN A REAL AND NEAR-REAL TIME DATA WAREHOUSE

PROVIDING COMPREHENSIVE SERVICES TO HEALTH INSURANCE PLAN ADMINISTRATORS AND INSURERS, THEIR CUSTOMERS, THEIR PROVIDERS AND THEIR HEALTH PLAN MEMBERS, NAMELY, THE CREATION AND AUTOMATED ADMINISTRATION OF HEALTHCARE INSURANCE BENEFIT PLANS, PROVIDER CONTRACTS, MEMBER CONTRACTS, AND RELATED TERMS AND RULES THAT HAVE BEEN CONVERTED TO A NATURAL LANGUAGE-LIKE CODE THROUGH THE USE OF CREATION AND EDITING SOFTWARE TOOLS; PROVIDING AUTOMATED, REAL-TIME TRANSACTION PROCESSING OF HIGH VOLUME, INFORMATION-RICH TRANSACTIONS SUCH AS INSURANCE CLAIMS, ENCOUNTERS, BENEFIT PLAN QUERY-RESPONSES, MEDICAL MANAGEMENT ADMINISTRATIVE TRANSACTIONS SUCH AS REFERRALS AND AUTHORIZATIONS, AND OTHER RELATED HEALTH INSURANCE ADMINISTRATIVE TRANSACTION TASKS; PROVIDING ACCESS TO AND ALLOWING ON-LINE, REAL-TIME, AND NEAR-REAL-TIME ABILITY TO REVIEW, INPUT, REVISE, AND VERIFY DATA AND CREATE REPORTS ON THE CURRENT AND HISTORICAL DATA AS MAINTAINED IN A REAL AND NEAR-REAL-TIME DATA WAREHOUSE BY THIS SAME SOFTWARE SYSTEM