Claims & Policy Management
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Challenges
Our client is one leading provider of Claim management a stronger foundation base in the market since 1989. The company is strongly into operations like File Handler Enterprise, Policy Handler, and our customized solutions have helped our customers manage their business needs for over 31 years. The claim management can modify existing products and customize products as per the customer needs
Also, this product has many modules like add claim, first notice, post payable, view checks, recursive payable, billing, user management, and screen builder.
The client decided to develop this application because of certain challenges that they faced in their daily operations that obstructed or delayed most of their business tasks such as :
- For understanding the product we required more focus to make changes in existing apps and make it customized.
- Screen builder is an additional feature that generates a complete dynamic form with complete crud operations.
- Product has standard functionality and without affecting that we need to integrate new changes.
- It’s fully dynamic form generation, hook up design-related changes is quite interesting
- System architecture is a little bit different as we generally have, so need to pay more attention over there.
- In systems, the utilities available for various operations are identified.
- We also need to develop a windows service that will import/export files from the FTP server without UI interaction.
Expertise
Tools & Technology
- Asp.NET
- MVC
- C#
- jQuery
- JavaScript
- Exago
- Microsoft Visual Studio
- Microsoft SQL Server
- Windows services
Solution
To meet our customer’s business demands, TatvaSoft developed a customized and integral app that can be altered without affecting existing code and functionality. Like its product, so for every client, we need to develop changes and hookup that changes with respect to client applications. We also need to develop a few additions of windows service that will perform certain actions after a particular time interval.
The client wanted a single Policy Handler platform that is web-based and completely policy management system for Workers' Compensation Administration. This software solution for policy administration is designed to support all phases of the policy lifecycle. Policy Handler’s capabilities include data-driven rating tools, quoting, automated renewal processes, billing, and optional workflow tools. Our software is up to date with the latest policy tools, dashboards, and functionality that companies come to expect from their policy administration software
Here are some of the vital modules of clients' applications developed by leading technology experts of TatvaSoft.
Claim Management using risk company
- User can directly enter claim details and generate a claim
- Users who don’t have rights will first have to create a notice which is similar to claim details.
- Created first notice details will be converted to claim and assign some required details
- If the user wants to delete the claim, then it can be done by deleting the claim
- Line of business is one of the important areas of claim management that can be changed by change the line of business
Claim payment process
- Post payable, Post recurring payable, Post non-check payment- everything will be managed here.
- View check, enter reimbursement, Reconciliation check register can be added using this module
- Generating manuals is simpler and possible using this module
Invoice
- File Handler Enterprise features a complete-time billing system that provides our users the ability to invoice effectively for their time. Post Time and Expenses transactions for services, post flat fee transactions, and create and print invoices all within the application
- The billing module offers both direct and agency billing services that include a scheduling tool that allows defined premium payment amounts and frequencies. Additional features include self-report and installment bill processing, past due processing, and billing reports.
Screen Builder (SB)
- Screen builder is a core part of this project from here the UI of the app will be designed.
- Generate new form, add controls, the page layout will be set from here.
- If some database query required in the form will be created using this module.
- Users can create lists which might be useful for some dropdown or other thing can be created from here.
- From SB users, they can customize Menu as they want and can link up the pages too.
- Whatever the form will be created using SB and can be exported to another database using import/export functionality.
Reporting
- For reporting, we are using exago reporting tools.
- Users can schedule various types of reports.
- Reports can be generated in different formats such as xlxs, pdf format.
Policy
- This is capable of providing different lines of business policy quotation.
- Application can automate a user-defined policy workflow process by applying a number of days prior to expiration, as well as routing rules. The results are system renewal quote creation with notification to the underwriting staff for review and analysis of the policy’s premium and loss history.
User Management
- Add / modify /Remove users
- Define roles for the system for further use.
- User management and provisioning establish a user's rights to information within an organization. The management part deals with adding names and passwords to electronic directories along with the assignment of rights
Result
Using the application, the customer can now effectively take advantage of numerous business profits from a customized business app. It is beneficial to the health sector and several other industry domains for managing all types of claim management.
- It reduces lots of paper works and also helps to import data from one application to another application.
- All the report prints are managed on exago reporting platform so that it can be easily accessed from the system.
- It improves automation in claim management activity.