Non Financial Case Studies

Innovative Solutions for non Financial Challenges

Claim Management Platform

Problem Statement

A Healthcare Insurance organization needed a system to capture, store, and process information from healthcare claim forms such as HCFA (professional claims), UB (institutional claims).

Solution Implemented

A web-based application was developed to easily and effectively capture data from the claims.

Data validation rules were implemented to ensure the captured data meets client requirements.

A rule configurator was provided to clients to update the data validation rules as needed.

Claim auditing was implemented to maintain and protect the captured claim information.

Various report formats were provided for analysis and reporting of claims data.

Claim Data Extraction Platform

Problem Statement

Despite having an application to capture claims data, a large quantity of claims remained pending for processing.

An automated data extraction service was needed to reduce backlogs and process pending claims.

Solution Implemented

A service was developed to extract claims data automatically without human intervention using OCR technology.

The open-source Tesseract OCR engine was used to reduce costs while enhancing data extraction accuracy.

Automated rules were implemented to ensure accurate and corrected data capture.

EDI Parser and Generator Service

Problem Statement

Healthcare insurance companies receive and exchange data in various formats, requiring a system that could handle different formats like EDI files.

Solution Implemented

An EDI Parser service was developed to parse various types of EDI files such as 834, 837, 999, etc.

An EDI Generator service was developed to generate EDI files from captured claims data.

Letter Generation Service

Problem Statement

If a claim is rejected, the insurance company must inform the provider or patient, but preparing a large number of letters manually was a cumbersome task.

A claim rejection letter generator system was needed to automate the process of generating rejection letters.

Solution Implemented

A rejection letter generator application was developed to generate letters for rejected claims.

Template-based letters were generated as per the client's specific requirements.

Overall Benefits (ROI)

Overall Benefits

Increased accuracy in capturing sensitive healthcare data.

Faster per-claim processing time.

Reduced per-claim processing costs.

Improved data portability and security.

Reduced human errors significantly.

65% reduction in claims processing backlogs.

75% reduction in the time required to process monthly claim files.

Property Booking System

Problem Statement

Booking the best and affordable property for vacations was a challenge for users.

Handling a large number of booking requests posed a challenge for property managers.

The client needed a solution to address these issues effectively and streamline the process.

Solution Implemented

Developed a system for property managers to easily register and list available properties.

Configured unique email addresses for each property manager with email parsing capabilities to streamline communication.

Implemented a centralized database that is updated via APIs from property management systems, ensuring real-time data synchronization.

Parsed and stored booking requests in the centralized system to ensure organized and efficient processing.

Utilized the SendGrid API for mass email communication, allowing property managers to quickly respond to users and confirm bookings.

Enhanced user experience with property availability projections and alternative options, making it easier for users to find suitable properties.