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EVRY India Facilitates Intelligent Integration of Insurance Data

As one of the largest service providers within the healthcare industry, the customer focused on providing third party liability identification and recovery services in the United States. The customer has been associated with more than 45 Medicaid agencies, numerous state health programs and over 50 government-sponsored healthcare plans.

The scope of this project involved processing multiple file formats of various providers’ data and load it onto a centralized server. Data uploading was to be conducted followed by Quality Assurance process. Each time the customer acquired new clients, the existing information from insurance claims had to be integrated and consolidated in order to enable efficient claims management.

 

Challenges

  • Identification of reusable maps from different provider mappings
  • Development of application for Quality Assurance process
  • Understanding the complex data structure of legacy data
  • Heterogeneous source data formats from delimited COBOL and EBCDIC formats
  • Balancing the financials and control the total to source systems with perfection
  • Manage huge volume of data from few a gigabytes to terabytes

 

Solution

EVRY India came up with the design and development of an end-to-end solution to load provider data. We helped with the implementation of a web portal approach for effective and efficient handling of provider data. Identification and development of reusable maps helped to reduce the cycle time to implement new loads of provider data. We further provided a well-defined process and workflow for conversion, and introduced multi-staged migration and verification process. The incorporation of parallel load and static key generation features also eased the entire procedure.

 

Result

The significant benefits to the customer included quicker turnaround time (reduced by 60%) to implement new provider data and reduction in time consumed (decreased by 40%) in the quality assurance process between load and production phases.