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health claim processing app .

We assisted the client automate their process for better claims management for revenue generation.





About Interdent

The client is one of the largest Dental Services Support provider to multi-specialty dental practices in US.They were already offering a plethora of services to dentistry services in the areas of general, orthodontics, periodontics, endodontics, pedodontics, prosthodontics, and oral surgery to over 1 million patients annually.

Intedent relaized that while its services was simplifying a lot of processes for its customers, there were a number of challenges that they still faced in terms of healthcare insurance claims. They wanted to tackle challenges like the missed /duplicate claims, slow processing, insufficient reports, insufficient information claims, etc. And this is what the client came to us with.

Country
United States

Industry
Healthcare

Partnership
16 Years strong

200+ Dental Centers
1 Million+ Annual Patients
80% Reduced Manual Errors


Partnership goal

To build an insurance Claim Processing application to simplify the complex processes


Goals

To resolve the issue of missed, slowed down, or wrong claims. Enhance the workflows in claim processing and add dynamic business rules. Remove inconsistencies caused by manual processes and while maintaining numerous processes.

Solutions

We prepared a comprehensive plan to cater to their requirements. We trusted role based security to design the app to ensure access limitation to users. The app also had page-level and control-level access along with features to manage workflows, tele-calling requirements, EDI claims, and more.





Our Involvement

Development Partner To Design & Build The Claim Processing App


The Start

The client, Interdent, is a leading player in the dental healthcare industry. They realized that their customers were facing difficulies in claim processing, which in turn, affected their overall revenue. They wanted to make the claims processesing system quicker, more steamlined, and well-managed.

The customer came to us with the idea to redesign the entire workflow and generate reporting of all open claims. We started with working on the entire database and built this enterprise-level application.

The finished product allowed users to view complete claim processing and the management to track everything for each department. It helped them reduce claim period by 40%, reduce errors by 80%, and achieve 95% success in identifying duplicate claims.



The Technology Stack

01
We used Microsoft .Net 4.0, Entity Framework, and LinQ as the app's core technologies.
02
For the database, we used ETL, Data Warehouse, SSIS, MS SQL 2008, SSRS 2008 and Visual Studio TFS for IDE and SCM.
03
The core technologies used were PHP 5.x with Twitter and Facebook API integrations.






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