Innova Solutions > Application Services > Product Engineering > Enterprise Applications modernization for Healthcare services

The 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.

Customer Need

Production Engineering team has more responsibility to monitor live volumes and fix the production issues by researching and providing workaround solutions based on priorities within stipulated time before SLA.New client implementations, environment setup, deployments, firewall, storage, Active directory setup, domain user groups/access, webservice, etc., are handle by production engineering team where more manual efforts are being done to implement single payer and provider. 300+ Vendor users, accessing our application for claim processing (~50K daily) at verifier step facing latency while keying, loading batch images and processing. Root cause differs time to time when more users accessing the application. It might be image dpi size, External ISP or client network issue, jobs running background, database performance issue, Time outs, webservice call, unhandled exceptions., It impacts production outbound file generation.


Solutions Provided

The client wanted us to identify the main repetitive tasks in production and automate the process to fix latency issues. ​ The team developed an  inhouse support tool to fix the corrupted and timeout batches in the workflow on processing huge claim volumes.​ Application Security Tool is developed to grant privileges for domain user groups to access application features on implementing new client across workflow, queues,.​

Developed EOBConfig Tool, V2 Designer tool to implement new clients in production and setting up client environments. For Network and firewall connectivity we used Filezilla, Core FTP to troubleshoot client bank FTP site. ​

OCR accuracy is dependent on the quality of image processing. To improve the quality of document images, Grooper offers over 20 unique image processing commands. It offers Image Processing, No Zonal OCR or Templates, Fuzzy Data Handling, Adaptable Integration, multi-language data processing etc., By implementing Grooper automation we were able to cutdown indexing time by 70%, manual data entry and latency in workflow verifier step can be reduced.​

Benefits / Results

Reduced the probability of manual errors while deploying the changes and fixing production issues. Implementation time of payers and providers in our system reduced comparatively than earlier by using inhouse tools. So far 230+ providers and payers are configured in short time. Increased the efficiency and resolution time for production change request tickets and issues.

Manual data entry is expensive, error-prone, and slow. So, we upgraded to Grooper data integration system, it greatly reduced costs by downsizing the manpower, improved Workflow Productivity, and accuracy in claim processing.

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