Electronic Remittance Advice (ERA) service provides claim payment information in the HIPAA mandated format by shortening the reimbursement cycle and streamlining the workflow.
Client is the single largest financial and administrative healthcare network in the United States, reaching approximately 750,000 physicians, 105,000 dentists, 60,000 pharmacies, 5,000 hospitals, 600 vendors, 450 laboratories and 1,200 government and commercial payers. The client has developed this network of payers and providers over 30 years in the industry, connecting virtually all private and government payers, claim submitting providers and pharmacies in a hybrid cloud based, user-centric and secure infrastructure environment. In 2013, the organisation was included as part of the Information Week 500 list of Top Technology Innovators in the United States.
The client wanted to Retire JCAPS and improve performance, reduce cost and velocity. They were also looking for a futuristic model that would ease their workloads.
The client also wanted a reusable framework for migrating applications like transaction data repository (TDR) to AWS.
Processes were inefficient, productivity was low, and costs were high.
To ease the workloads, Innova leveraged cloud expertise and renovated the following:
Redesigned the applications to run independent of JCAPS services such as web services, validations, transformation, streaming, and others
Replaced Oracle DB to AWS MySQL RDS
Migrated cXML file storage from Oracle DB to S3
Redesigned the code to use S3 for cXML file storage instead of Oracle database
Replaced MySQL RDS in place of Oracle DB for storing the persistent storage of transaction data
Introduced pipelined processing-SNS based file S3 file activity monitoring and processing using lambda
Integrated Redshift and TDR
Integrated the application with the universal datastore for all transaction data across the enterprise using Kinesis framework