Product Configurator Powers Claim Validation & Computation Solution For Third Party Administrator
Product Configurator Powers Claim Validation & Computation Solution For Third Party Administrator
2 PagesOur client is a leading Third Party Admin- istrator handling health claims for multiple insurance carriers rendering a variety of services such as provider networks, nurse case management, claim processing and settlement. Our Client was embarking upon an initia- tive to improve the operational efficiencies and ease of use of its Claims Processing System Our Client was on a quest for a rule driv- en platform to process claims for multiple products. The incumbent claims management sys- tem required more manual interventions to check the validity of the claim. Chal- lenges included: ? To validate the claim based on prod- uct specific eligibility criteria ? To synchronize with the Core Appli- cation System ? Introduction of a new products from multiple carriers . ? To assess t
