Comat's Healthcare Case study - Transit Insurance Billing Application

		Home > Solutions and Services > Healthcare > Case study - Transit Insurance Billing Application >>

	Case Study - Transit Insurance Billing Application

The Challenge

A leading transit insurance company required design and development of independent billing application integrating legacy claims system. Client had disparate systems to automate and managed day to day functions unconnected in the claims operation group. Current systems were all legacy, focused towards the operations of the specific departments. Moreover there was no inter-communication between various applications leading to redundancy of data. The challenge was to build an independent re-pricing module providing a full fledged application with import/export capability for interface with legacy ‘Claims System’ and service multiple entities.

The users of the system are not very tech savvy. Eliciting and gathering the requirements was one of the key challenges. To overcome this, the requirements elicitation team interacted with the users following a methodical approach to understand the business problems. The understandings were documented and made available to the users and the management for their approval.

The Solution

We at Comat co-created the independent medical billing application. This system enabled the client to re-price the claims as well as generate EOB as the output. Additionally, the client management and customer support modules will be built to cater the needs of end customers.

A systematic study of the client’s operations was conducted and documented. The various activities were segregated and grouped into modules. The implementation and release of these modules were undertaken in a phased manner. An Object-Oriented architecture with a scalable framework was designed. Authentication & rules to access data, Mechanism to retrieve data and Handling multiple Databases were put in place.

The Package

What really made the difference to the whole package was the ICD and CPT engine integration. The disparate legacy systems of various departments within were automated.

Cost reduction on services by more than 40% compared to the same work being done by local contractors. The solution was developed using Microsoft. Net set of technologies viz. C#, ASP.NET, COM+ and MS SQL. The solution was built on N-Tier architecture comprising of UI Layer, Business Object Layer, Transaction Layer and Data Access Layer.

The complete architecture was distributed in nature and this was implemented using .Net Remoting. The Database was designed and normalized for optimal performance at peak loads and catered to concurrent usage.