Seamless Claims Management Process with a Progress Based Integrated Claims Administration System - Case Study

DotThe Client

The client is a leading global provider of technology-enabled risk, benefits and integrated business solutions, located in 65 countries.

DotThe Challenges

The major challenge was to help the client with a single-user environment. The users had to switch between multiple software systems in order to find all the relevant information on a specific claim, which made the process cumbersome.

 

Hence, to improve the efficiency of claims management, there was a need for the consolidation of claims systems into an integrated claims management system, to have all pertinent data in one platform that would eventually reduce and eliminate the quest for data. Additionally, a user-friendly interface was also required, to easily access the information required by the user.

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DotThe Objective

The client being a leading global provider of claim management services, risks and benefits solutions was required to deliver cost-effective risk consulting, managed care and other services. Hence, they sought a technology partner to help them in key business functions such as worker’s compensation, casualty, managed care, disability, centralized security, master data setup/configuration and strategic initiatives.

 

They aimed at smooth functioning of the claims management and payment transactions for the settlement of customers’ claims to offer a better end-user experience. Hence, there was a need to integrate their homegrown applications to provide an integrated administration system.

DotThe Solution

Our team consolidated the claims management into a Progress based integrated application to provide the user with a single sign-on facility and claim information in one place. The existing framework and architecture were also modified to enable the entire application to function seamlessly after the new single sign-on. This saved on a major re-development of the application, hence optimizing time and cost. The application was developed leveraging OpenEdge 11.6.

 

Furthermore, the existing user interface was enhanced and modernised using Telerik controls to provide an engaging and user-friendly application. The unique features like tree view, grid view, ribbon bar, collapsable panels and page view were introduced. This allowed the major screens to be modernised without change in the technology stack.

DotThe Benefits

  • The integrated application provided direct and centralized access to the pertinent claims information in a single application.
  • This simplified the claims management process while reducing complexities and achieving operational excellence.
  • It saved a lot of time for the users as they can work on more claims rather than having to spend time searching for the claims in different databases based on file number.
  • All the information linked to the claim was now available after the single sign-on and each and every existing functionality worked seamlessly even if the claim data is fetched from a different application.
  • The progress-based integrated claim application enabled a better graphical user interface for searching data, filtering data, getting consolidated information on the screen.
  • Usage of Telerik controls opened the window for the client to enhance & modernize the existing UI of the application and enrich it with additional features and give it a modern look and feel.

DotHappy Customer

The ClientService Center Representative

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The Claim Management System is making my life much easier by not having to switch back and forth in all the processing offices.

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