DIGITAL ENTERPRISE PLATFORM
TO IMPROVE & OPTIMIZE REVENUE
COLLECTION MANAGEMENT &
MEDICAL COVERAGE SERVICES

healthcare

A leading healthcare service provider specializes in revenue cycle recovery process
from business office to legal services. They utilize the latest technology, best practices
to achieve optimum results and maximum resolution for their clients

IMPLEMENTATION BENEFITS

  • NextGen Web Application to support Revenue Collection and Recovery Process, Accident Claims, Billing, Early Out, Complete Guidance & Advisory on Medicare Plans and Simplified Enrolment, Provide Zero Interest Loan Program
  • Lead and Opportunity Management for Medicare using Salesforce platform
  • Web Application for Client Setup, Client Services Management, Rate Card Setup & Management
  • Web Application for Management of Claims due to Company for the services it provided
  • Integration with Application for Document Processing & Bar Coding, Digital Printing & Mailing Service
  • Integration with flexible online payment for quick payments, setup future & payment plans and choose right settlement options etc.
  • Integration with Secure Email Solutions for every Business
  • Various Frameworks to support self service capabilities for IT Admins rather depending on the OOB eliminating the license dependencies
  • Integration with Hospitals & Health Care Services providers for Debt Collections Referrals, Payment Services, Insurance Details, Legal Details etc.
  • Enhanced User Experiences: Ease of use, Simplified Process, Better experience, Customised Look & Feel, Drag and drop to select/filter the fields, Better

PROJECT DETAILS

  • Build Next Generation Digital Platform with AI Powered Revenue Collection Management, Billing & Collections, Medical Coverage & Advisory Services
  • Build Framework and tools such as Data Imports/Exports with translations, Business Rule Engine, Dynamic Window Generation with business logic, Data Repositories which will be foundations for many frameworks, Scheduler, Events/Triggers/Trigger Actions which can be associated with any process with in the platform
  • Integrate with Hospitals, Healthcare Service Providers, Insurance Providers etc.

CHALLENGES

  • Requirements are not specified and needed understand the existing application, reverse engineering and data model in existing database to define exact requirements.
  • Migration of enormous table (4000 tables) & data (3 TB) from existing onpremise legacy database to Cloud RDBMS database Platform
  • Integration of vast number of File Processing and Report Generations Programs with stakeholders.
  • Building Various Frameworks in the platform rather than using OOB solution.
  • Building the offline functionalities for Onsite Patient Advocates and Sync with Platform when they are connected to internet/network and handle the complex data synchronisation with data integrity.
  • Build robust, responsive, scalable and secured Web Application and Integrating with various stakeholders of the Platform
  • Needed to ensure the robust testing process for end to end testing, enabling automation testing etc. as there were limited UAT.
  • As this is platform with many application, managing and deploying the application in cloud with DevOps process
  • Defining the Platform Architecture and making sure all the component integrated and work together for the entire program which involve various technologies

  • DIGITAL

    TRANSFORMATION

  • PRODUCT

    DEVELOPMENT

  • FRAMEWORK

    DEVELOPMENT

  • CX/UX

    DESIGN

  • CLOUD/DEVOPS

    ENGINEERING

  • ARCHITECTURE

    ADVISORY

  • QUALITY

    ASSURANCE

TECHNOLOGIES

  • Front End: ReactJS, Redux Pattern, S3 Cloud Front, HTML, CSS
  • Backend: Java Spring Boot, NodeJS
  • Repositories & Data Store: PostgreSQL, Redis Caching, RabitMQ
  • Workflow & Rule Engine: Custom Framework, Drool, Camunda
  • Integration: Custom Framework
  • API Gateway Services: Zuul & Spring Cloud Gateway Services
  • Deployment: AWS Cloud Services
  • Package Application: Salesforce

SOLUTION

  • NextGen Intelligent Web Application with Automated Workflow, Orchestrations, Decisions & Dynamic Rule Management
  • API First Approach to promote reusability, faster development etc.
  • Integration with all the stake holders such as Hospital & Healthcare Service Providers leveraging Report Generator and Data Manager
  • Conversational AI & ML: Recommendations, Conversational AI/Voice Bot, Notes (Spell Check, NLP based Speech to Text)
  • Web Application Offline Sync capabilities using React JS PWA with Redux Pattern and AWS App Sync Service with GraphQL Resolver
  • Self Service IT Capabilities with various Frameworks for Role Management, Dynamic Window Generation, Report Generator & Integrator, Business Rule Engine and Event Trigger, Letter Management, Global Fields Management, Scheduling and Job Management
  • Scalable Architecture: High Availability and Fault Tolerant Architecture on AWS Cloud