Development of Claims Management Software

Development of Claims Management Software

Industry
Information Technology
Technologies
MySQL, PHP

Customer

The Customer is a European company that offers technologies, solutions and services for intelligent transportation systems.

Challenge

The Customer was looking for a partner to develop a web-based software solution that could reduce the claims registration and processing time and efforts and improve response quality. The Customer wanted the new system to allow:

  • Managing claims processing workflows.
  • Generating automatic claim decisions in printable format.
  • Attaching documents to claims without browser usage (single and multiple page scanning capability).
  • Searching for registered claims with different statuses.
  • Generating KPI reports.

Most of the Customer’ infrastructure was outdated. Thus, the new system had to be optimized to work on older PCs with older versions of Internet Explorer (IE 8 +).

Solution

Experienced in web application development and delivering fleet management solutions, ScienceSoft was chosen to build the solution. The new system was developed in three phases.

User experience analysis and design.

Working closely with the Customer’s team, ScienceSoft’s UI designer and business analyst developed a clean user interface and prepared comprehensive system requirements specification. Lead technical specialists came up with the technical specification and processing algorithms.

Software development.

Database development. ScienceSoft’s developers created a centralized data repository with role-based access and convenient claims processing workflows with user-friendly interfaces.

Scanning solution development. ScienceSoft’s .NET team delivered a desktop .NET application to run the scanning process and automatic uploading and attachment of scanned documents to claims without using the browsing option. ScienceSoft’s team also developed solutions for the application installation and auto update.

Web application. ScienceSoft’s web developers delivered UI and business logic for claims registration and processing application. ScienceSoft’s team opted for displaying web forms in simple HTML using current back-end API methods, simple views and minification of JavaScript and CSS files to ensure smooth application work in older IE versions (8, 9).

Claim processing included step-by-step claim decision making that was done automatically by the system with a possibility to add comments and make adjustments by authorized users. It was also possible to return a claim back to the creator and request specific adjustments.

Each claim was assigned to appropriate employee according to user role, responsibility and department within the company.

Possibility to automatically combine same decisions for sub-claims into a single response was also developed. Once the final decision was generated and approved, it could be easily printed.

Claims search function was developed using ElasticSearch. The service offered fast auto-complete look-up functionality for finding claims, including searching the archive. Advanced search by various parameters was available as well.

dev-of-sys

ScienceSoft development team has also created a mechanism for finding and importing claim-related information from external Customer’s systems and exchanging additional claim-related information between the company’s departments. All additional info request tickets were processed within the system.

Ability to check whether a registered claim had a double record and ability to manage different selections were also implemented.

Since multiple departments were involved in the process, the system offered sophisticated role-based access. Each employee was only able to review the information allowed for his role in the company.

A back-end web dashboard was created for users with admin privileges. Administrators were able to manage users/roles/permissions, setup e-mail notifications with rules and tags, set and edit claims classifications, manage templates for answer generation. They were also able to tune decision-making algorithms by utilizing graphical interfaces with drag and drop option. Various reporting functionality with built-in filters and an export feature were developed for admin and regular users.

3. System stabilization and user training.

  • ScienceSoft’s quality assurance team worked together with the Customer’s team on functional, integration, compatibility and security testing.
  • ScienceSoft’s team created user manuals and conducted several training sessions.

Results

ScienceSoftäs developed claims management system that integrated user’s web interface, administrative functionality, search service and a scanning application. The new solution was successfully delivered and implemented.

As a result, the Customer’s claims processing process became simpler and more efficient, and the number of staff required to work with claims was reduced.

Technologies and Tools

PHP: PHP 5.6, PhpStorm 2016.2, Symfony 2.7+, Doctrine Object Relational Mapper (ORM) 2.2+, Ext JS 6.0+.

.NET: Windows Image Acquisition (WIA), TWAIN.

Server configuration: RedHat 6, Nginx 1.8, MySQL 5.6, Elasticsearch 2.3.5, Apache OpenOffice 4.4.2, Java 8.

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