Case Study - Insurance eBusiness

The Challenge

Based on an assessment of current capabilities and available technology, a national insurance company realized the need to improve business processes to maintain their competitive advantage. They developed an e-Business concept known as the Internet Self Service Center (ISSC). The ISSC became a collection of “toolkits” that deliver enhanced service offerings to customers while increasing operational efficiency within their own business.

The Solution

A.J. Boggs was contracted to support the IT team at this insurance carrier. The functional requirement was to provide an Internet application that supported transaction oriented claim processing, electronic payment, and statement rendering. Each participating service provider office needed to be able to enter claims using a personal computer connected to the Internet. The system had to be secure and offer each service provider access to information related to their particular practice. The design phase provided a list of functional requirements and performance specifications. In addition, the following guidelines were set for fielding the system: minimal disruption to existing business process; integration with the existing mainframe based adjudication processes; and seamless transition for the user community (reuse existing forms and programs as much as possible). A.J. Boggs provided analysis and design using the Rational Unified Process, which led to the re-engineering of the business process. The design and development of the necessary programs were completed using JAVA as the primary development language, VBSF for mapping and an MS SQL Server 7 database.

The Results

Critical to implementation success was the project management philosophy stressing interaction with internal and external users. Today participating dental care providers submit their claims via the Internet, receive payment electronically and are able to review at any time the status of their submissions.