The Billings Clinic uses Cerner for their registration/scheduling system and MISYS for their clinical billing. MISYS does not currently support insurance company prioritizing via interface. Their solution is to send a 'farm' of 15 Boston WorkStation sessions every HL7 ADT update or discharge that has insurance information and script it to update the insurances in MISYS, then report the status of each transaction to a SQL Server that feeds a web portal used by registration and billing staff. The Billings Clinic processes about 100,000 encounters per year, and each encounter is sent multiple times. They project that they are processed one million records in the first year and saved approximately 15 FTEs and $450,000.