Case Study: Health Insurance Denial Application

Client Background:

This client provides technology solutions and services for healthcare and hospitals. They provide health information services to collect information related to healthcare from hospitals and manage this data from single central location. Their objective is to simplify the different processes performed within different hospitals at regular interval of time.

Project Purpose:

The purpose of the project is to document the processes at central location, which can be administered by the company owner and updated at regular interval. There should be flowchart / UI diagram that can be easily read / written, understood and distributed among end users. As the hospitals are placed at different physical locations therefore they need to maintain unique repository for the respective information. The main purpose of developing this application was - different people with respect to their designation and irrespective of hospital locations should be able to monitor their employees work through electronic media.

Solution:

We’ve developed a process and have built a tool that has helped the client to guide the staff through how to handle each insurance claim follow-up and denial. The process was designed and entered into the tool by the company’s qualified and experienced administrators. The staff would then have step by step guidance on how they could work on accounts. The purpose of this software was to create a system which when updated would give the general staff a step by step guide on how to process claims. The software could also easily be updated when a process changed and information dissemination through it also ensured that everyone had the latest information at all times.

Overall, claim process is made easier, faster and accurate!


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Platform:

  • Code Igniter (PHP)
  • Ms SQL Database
  • jQuery
  • Go JS
  • Project / File Versioning is maintained on SVN