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This global fortune financial services firm needed a portal which can be used by internal employees to view the member medical history of all the subscribers, claims information, agent’s information and provider information with various security features for different users of the portal such as underwriters, agents and customer service representatives. Client : A Fortune US Global Financial Services Major (Client) Business Need: This Client has been a provider for Medicare supplement insurance, sold by over 4,200 agents nationwide. The Client required a portal which can be used by internal employees to view the member medical history of all the subscribers, claims information, agent’s information and provider information. The portal should provide various security features for different users of the portal such as underwriters, agents and customer service representatives. Solution: STAT9 Technologies has helped the Client in Design, Development, and Testing of the ACI portal which has several pages of customer information in a structured way so that the user of the system can easily navigate through the portal. The users of the portal were given different rights so that the information of the customer cannot be visible to all the users of the system. The portal has been built using following technologies Microsoft .NET 2.0, SQL Server 2000, C#.NET and ADO.NET. The portal has been made more secure using windows authentication. All the customer data is saved in the SQL Server database, which is more secure. All of this customer data is being displayed in the form of reports to the internal users. The reports are built using SQL Server Reporting Services 2005. Benefits: With this portal it has been easy for all the users of the system. The advantages of the system are This fortune American Bank required a clearing house type of solution for healthcare claims payment processing that enables providers to automate claims reimbursement and reduce administrative costs. Company: A fortune global Bank in the USA (Bank) Business Need: This Bank is one of the leading provider of electronic remittance services for Healthcare Insurance Portability and Accountability Act of 1996 (HIPAA) compliant transaction sets. Bank required a solution for healthcare claims payment processing that enables providers to automate claims reimbursement and reduce administrative costs. For electronic transactions, Healthcare Link should receive electronic transmissions or extraction of files from insurer sources. The data files should be customized, allowing payment information from paper and electronic sources to auto-post to practice management systems. The critical task of matching data to payments should be done automatically. Healthcare Link should also provide a powerful content management toolkit, including a payment search engine, online reporting, integrated workflow and reconciliation support. Solution: STAT9 Technologies was deeply involved with the bank to develop a healthcare link website which is highly flexible and secure so the providers can login to healthcare link site and can automate the claim reimbursement. To support the transition from paper to electronic posting, paper payments and supporting materials are scanned at Banks Healthcare Centers of Excellence and converted to electronic files. To read these electronic files, the bank has adopted different solutions. Healthcare link website is built on the Microsoft .NET framework with technologies including but not limited to SQL Server 2005, service oriented architecture (SOA) and XML Web Services. The website has been built with four tier architecture model so as to make the system highly secure. To migrate the data from electronic files the Bank has written some flexible windows services which automatically detect the files and loads the data into SQL Server database. Benefits: With Healthcare Link the providers can:
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