FACILITATING A SOPHISTICATED SOLUTION WHILE ENSURING DATA ACCURACY

SUMMARY

A prominent US healthcare insurer urgently needed to modernize its outdated financial systems, which relied heavily on manual processes and were no longer sustainable. ZIO-soft was tasked with implementing a scalable solution to address these challenges.

SOLUTION

The client sought a cutting-edge billing solution to serve both existing and potential clients in a fiercely competitive market. Despite previous efforts with off-the-shelf solutions, none proved suitable. Key requirements included the ability to conduct ad-hoc billing runs during business hours and daily periodic billing without disrupting existing critical systems or necessitating additional infrastructure investments.

Managing vast data volumes while maintaining operational efficiency posed a significant challenge. Our focus was to enhance operator support and real-time event awareness within the system architecture.

The new system, built on an event-driven framework, efficiently processed complex data permutations for invoice calculations. Seamless integration with existing subsystems and third-party products was ensured.

Furthermore, there was a paradigm shift in the system-operator relationship. Previously reliant on operator understanding, the system now provides real-time support and event highlighting, empowering operators to make informed decisions.

OUTCOME

ZIO-soft’s tailored solution significantly enhanced the client’s ability to meet customer demands. Previously, billing runs were monthly and overnight, causing delays in customer billing. The new system enables:

  • Ad-hoc invoicing during business hours
  • Pre-computation of billing contributions
  • Near-real-time adjustment of contributions based on system changes

ZIO-soft’s implementation also improved data accuracy and security, limiting the risk of erroneous data exposure through innovative processes and architecture.