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Insurance Eligibility Workflow Engine - A Case Study
 

Insurance Eligibility Workflow Engine - A Case Study

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An e-Business application that computerizes eligibility workflow through a flexible, rule-based engine requiring no programming, this application enables quick authoring and implementation in the face ...

An e-Business application that computerizes eligibility workflow through a flexible, rule-based engine requiring no programming, this application enables quick authoring and implementation in the face of changing eligibility policies and regulations.

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    Insurance Eligibility Workflow Engine - A Case Study Insurance Eligibility Workflow Engine - A Case Study Presentation Transcript

    • HSTC301
      ELIGIBILITY RULES
      FOR INSURANCE ECOMMERCE PORTAL
      www.harbinger-systems.com
    • HARBINGER SYSTEMS
      Overview
      Harbinger Systems is a leading provider of software engineering services to some of the world's best product companies. Our services span solution consulting, software design, development, testing and test automation.
      By leveraging cutting-edge technologies, Harbinger Systems works with its customers as a partner in technology innovation.
      Services
      • Software Product Development
      • Web 2.0
      • Mobile
      • eLearning
      • Performance Engineering
      • Systems Software
      • Digital Marketing
      A Harbinger Systems Case Study
      www.harbinger-systems.com
      Follow Us
      • blog.harbinger-systems.com
      • www.twitter.com/HarbingerSys
      • www.facebook.com/harbingersys
      • www.slideshare.net/hsplmkting
      • www.linkedin.com/companies/382306
      Also Read Our White Papers…
      Interactive User Experience (IUX): Going Beyond Interfaces
      Comparing Adobe Flex & JavaScript
      The Enterprise Software Makeover Guide
      Five Javascript Frameworks: A Point-by-point Comparison
      www.harbinger-systems.com
    • ELIGIBILITY RULES FOR INSURANCE ECOMMERCE PORTAL
      Challenge
      Eligibility rules needed to be flexible and easily configurable
      Rules change frequently with time due to changing policies and regulations
      Rules implementation required automation with no programming
      Situation
      A brick-and-mortar insurance company creating an e-Business app to computerize eligibility workflow
      Harbinger Solution
      A binary-tree-based eligibility encoding proposed
      Intermediate nodes were eligibility questions and terminating node were actions
      Oracle RDBMS tables used to encode binary tree structure of eligibility workflow
      The largely static eligibility question nodes were encoded as DB stored procedures
      COM component developed to run through encoded paths and fire questions to arrive at required action
      Technologies & Tools
      Oracle RDBMS
      Binary tree representation in RDBMS tables
      Component Object Model (COM)
      Benefits
      Company encodes insurance eligibility workflow automation with no-programming
      Frequent changes in eligibility can be incorporated within hours instead of days
      BOTTOM LINE
      Company implemented a complex workflow automation that required no programming and maximum flexibility to match frequent future changes
      www.harbinger-systems.com
      HSTC301