e-Repricing Project

Summary

The largest niche player of travel health insurance in canada wanted to grow their business in claims processing.They chose repricing(matching a medical claim to a fee schedule) as the target area of growth. Inteq built a scalable .Net custom application which provided a flexible architecture to quickly implement changes in the fee schedule or easily change the match criteria.

Key Drivers

  • They did not have any technology to support the proposed business expansion
  • Manual process would involve several layers of personnel leading to operational costs and longer process times
  • They wanted a system that could accommodate changes easily.

Solution

  • A custom scalable.NET based system that was built on a EAI platform
  • Gentran Integration suite was used as the EAI platform to receive. format and track claims
  • Two phased approach to ensure that project scope was clearly established
  • Web application(.NET) implemented the core business rules
  • Parallel operations to prove code and data integrity

Results

  • Client saved over 40% using the blended on-shore model
  • Client expressed desire to execute more projects with Inteq
  • Client has chosen Inteq as their delivery partner in designing,developing and maintaining their IT systems

Atlas

Summary

The company develops and deploys sophisticated, high performance software applications,primarily for the healthcare industry. Their two flagship products LabWorks and WebCMR are designed for laboratories and public health departments to maintain lab orders and track outbreaks.

Key Drivers

  • 1. Products require frequent upgrades and customization to meet client requirements
  • 2. Client wanted to improve release frequency
  • 3. They wanted a system that could accommodate changes easily but without compromising quality

Solution

Inteq developed and implemented an off-shore testing service including:

  • Preparation of a comprehensive test strategy for system testing
  • Release management plan for QA, and implementation
  • Preparation of test plans for scheduling and controlling test execution
  • Test case Preparation and execution
  • Defect managements to track defects to closure
  • Trace ability matrix to ensure test coverage
  • Preparation of test data to ensure comprehensive testing
  • Release management

Results

  • Client is using this testing service for the past five years
  • Client has chosen Inteq as the premier testing partner for all the product enhancements
  • Inteqs has also enabled the client adopt better practices leading to improved product quality

Redwood Toxicology Laboratory

The existing ERP system for a major toxicology laboratory was custom developed in the early nineties using an older client server platform. It was not meeting the company's current business requirements. The company could easily triple their business volume, but were limited by antiquated technology. Attempts to customize a popular ERP package had cost over 2 million dollars but had totally failed to meet user requirements. Eventually this package was abandoned and Inteq was asked to provide a solution. Since the requirements were not well established, Inteq used its wholly owned subsidiary in the US (ACM Healthcare Technologies) to conduct a feasibility study. The goal of this study was to analyze and assess the existing ERP system, assess the preparedness to respond to future changes in business such as supporting new market requirements for clinical testing and support of the needs of other laboratories.

The specific areas studied in the assessment included the feasibility of a platform that is technologically current, easily maintainable and has the ability to easily grow and interface with a host of other customer information systems eliminating double entry, provide efficiencies in managing throughput, and better quality. Other objectives of the technology study was to enable management to have a real-time dashboard of performance, integrating financial, operational and customer information. The study recommended to include a data-warehouse that is seamlessly integrated with day-to-day operations to support data mining and trending. Based on the results of the assessment, ACM Healthcare Technologies proposed a three phased approach. The laboratory awarded Inteq the contract to implement the system.

Phase 1 Phase 2 Phase 3
Keep functionality the same and migrate to .NET Develop the detailed new work flow, business intelligence facility and integration with in-house financial systems Implement the business process changes defined in Phase 2

To help implement the phases, Inteq adopted its established on-shore/off-shore model. The on-shore work included developing the requirements and aligning it with the laboratory process. On-shore work was performed by ACM HT, a wholly owned subsidiary of Inteq based in the U.S. ACM HT has strong understanding of the healthcare market and a solid expertise in HIPAA and other compliance regulations (21 CFR Part 11). ACM Healthcare Technologies' business and technical analysts helped develop the RFP, the contract and quality acceptance criteria for the deliverables. They provided a fixed fee estimate and schedule. The critical aspect of the proposal was well articulated deliverables with quality acceptance criteria.

While the laboratory's CIO had complete management oversight, ACM Healthcare Technologies maintained and tracked the deliveries from a cost, schedule, risk and quality perspective. The customer had the assurance of on-site management, cost efficient off-shore development and exchange moderators who oversees the service providers performance. The key success factors were: well defined requirements, well defined work-breakdown structure, project status tracking, independent quality assurance, and acceptance criteria tied to each deliverable.

Inteq helped the laboratory save over 50% in total project costs using a blended off-shore/on-shore model. The laboratory has decided to use this blended global delivery model for other projects and has engaged Inteq as their primary partner in designing, developing and maintaining their IT systems.

Development of a data warehouse for a leading provider of travel insurance products and services

About the Client:

The client is one of Canada's leading providers of specialized travel insurance and health plans for individuals, groups and businesses. The Company, through its subsidiary, also provides assistance, case management, cost containment and claims services. The Company is exploring new avenues for growth has identified claims repricing domain as a future growth driver.

Business Need:

  • The client used multiple IT applications on different platforms and database technologies to deal with common enterprise functions such as sales, marketing, underwriting, claims processing, accounting etc.
  • Ineffective Business Intelligence: The functional fragmentation lead to a situation where it was increasingly difficult to obtain a single version of information which was reliable and accurate enough to make business decisions. The client does not have a well-defined process to assimilate and analyze data captured from various application data sources. Historical data is not available in a convenient form and format for analysis. The effort required to create reports that span multiple application data sources is cumbersome.
  • Data Inconsistency: Large part of the enterprise was dependent on the accuracy of the information and its availability and delivery for efficient decision making. Given the non-integrated nature of the IT setup at client, data integrity was difficult to maintain. Often the same data is stored in multiple applications. For example corporate client information is stored in various applications. When a corporate client requests change in information, data in all these applications needs to be modified. Configuring a new insurance product is a complex task. In the current system, products are setup in multiple systems. The possibility of inconsistent data across disconnected applications is high.

The client thus wanted to build an enterprise wide data warehouse that would help integrate data across claims, product, sales etc. from all transaction systems into a consolidated data mart.

Inteq solution and approach:

Since time was as critical as cost savings, Inteq used its Global Delivery Model and its team of ten personnel completed the project in 9 months. An enterprise wide data warehouse was conceptualised for tactical and strategic business decisions and to help improve client's competitive positioning. The enterprise wide data warehouse would simplify information access and standardise it across source systems. A consolidated data mart provides enterprise view of the organisations business for advanced analytics and reporting.

Inteq took ownership of the project and undertook the following tasks for creation of an enterprise wide data warehouse, which is required for tactical and strategic business decisions:

I. Designing the Data Warehouse and dimensional model
II. Creation of the data preparation area and data warehouse database

Leveraging on the experience across healthcare organizations, the team quickly came up with a scalable and flexible architecture keeping in view the enormous data growth expected in the industry.

III. Extracting data from operational systems into data preparation area
IV. Cleansing and transforming data in the data preparation area
V. Loading data into the data warehouse database
VI. Preparing presentation information for users
VII. Distributing data to data marts

Team devised an execution strategy which included data profiling at source, mapping of each source to target based on business requirements, comparing across sources to ensure consistency, data conflict resolution, end user involvement from beginning and interim releases by phasing the warehouse project.

Business Benefits:

  • Prior to this solution, client had to access multiple sources with no standard rules. The availability of this enterprise asset eliminated redundancy thus delivering a single version of information. This resulted in better decision making capability, simplified information access, and helped the client be competent in the industry.
  • Flexibility was also improved and the client could easily add newer data from sources that were not initially supported. This improved the capabilities of the data warehousing solution.
  • The client was able to contain administrative costs associated with maintaining multiple warehouses, and achieved considerable cost savings.
  • It simplified data exchange process which helped provide accurate data to vendors.

Sperry Van Ness

The Client:

Sperry Van Ness (SVN) is one of the largest commercial real estate investment brokerage firms in the US. SVN has about 900 agents, organized as Corporate or Franchised, and then by Region, Office and Sub-office. The SVN operation system (property tracking and publishing system) includes: Agent & User Management, Agent Websites, Property Entry & Update, Financial Analysis, External data & Wizards, Document Vault, Commission Management, Workflow Management, Publisher, Report Generation, Listing Alert and Intranet among a host of other features.

The Engagement:

SVN decided to use the blended global delivery model for maintaining and re-engineering their property tracking and publishing system and has engaged Inteq (through USourceIT) as their primary partner in designing, developing and maintaining their IT systems. The project is executed on a blended delivery model, with a project manager being onsite 25% of the time and the balance team offshore. The offshore team comprises of Software engineers and testers.

Maintained System Features:

A partial list of system features that are maintained by Inteq:

Core Listing Management System

  • Add, Edit, Clone, View and Manage Listing
  • 'Basic Listing Data' and 'Configurable Listing Data' by property type
  • Location, Owner/Buyer, Features, Highlights, Rent Roll
  • Financials, Comparables, Maps, Charts
  • Flexible "listing features" module (Similar to "Data Fields" module proposed by CCIM for the CCIMNet system)
  • Manage Property Images and Documents
  • Secure Document Vault for a Property
  • Listing Search
    • Basic Search, Advanced Search, Search By Map, Save Search

Additional Listing Related Features

  • Export property to Multi Listing Sites
  • Create Property Web Site
  • Create Property Brochures
  • Create and Send E-Marketing Blasts
  • Manage Advisors on a Listing
  • Listing Lifecycle Management from Proposal Stage to Closure
  • Commissions and Accounting
  • Import Demographic Information for a Property
  • Import Rent/Sales Comparables for a Property

Advisor Related Features

  • Manage Advisors, Setup, Permissions, Create Advisor Web Site
  • Advisor File Store, Reports

Technology:

OS Windows Server Family, Windows XP/Vista clients
IDE MS Visual Studio 2005
Scripting ASP.NET/IIS, C#, Javascript
Reporting Tool Crystal Reports for Visual Studio
Middle Ware COM+, XML, XSL, Windows Workflow Foundation
Database MS SQL Server 2005

MZI Healthcare

Client's Problem:

Client acquired EZ-CAP product in 2005 which is a leading product in the Health Insurance market. EZCAP is a fully integrated system that supports and manages day-to-day business operations of healthcare organizations such as HMOs, MSOs, PHOs, IPAs, specialty service organizations, medical groups, hospitals and government sponsored health plans. It has over 16 integrated modules including Benefit Enrollment and Eligibility administration, Claims processing and Adjudication, Authorizations, Capitation, Case Management, Internet Connectivity, EDI capability and HIPAA ready.

The Product has been installed in 130 clients in US and other countries. However, there was no release or version upgrade to the existing clients from 2001 and the same version is being marketed to new clients. In order to be competitive and meet the customer expectations the new management felt that product enhancement, modifying the existing features and migration to new technologies is of prime importance.

The main application is written utilizing Gupta SQLWindows. Finding resources in Gupta is one issue and the other issue is whether the Gupta has all the capabilities that are required for the enhancements. Hence the management would ultimately like to move away from Gupta and transition the product fully into Visual Studios.net.

The management also would like to explore new markets such as PPOs, POS, TPAs etc., for EZCAP penetration. In order to go into these markets the EZCAP product need to improvise on its capabilities and features suiting to the different business lines.

Additional Resources with the required skill set in existing and newer technologies to fine tune the product, develop and deploy new features, support with QA is required.

Solution Offered:

Inteq offered to setup an offshore team dedicated to EZCAP for Development, Maintenance and QA support. A team of 70 members were put in place for handling the assignment. The assignment is divided into two distinct projects maintenance and migration.

Maintenance Project:

Maintain System:

  • Product level support which is mainly corrective maintenance for issues raised by clients
  • Handholding clients for installation, configuration and production issues
  • Product enhancements with impact analysis, design, development, testing and coordination of release
  • Helping the client support in resolving issues

Maintain Bug / Change Matrix:

  • Tracking of bugs through their life cycle from opening to closure
  • Resolution of bugs assigned to maintenance team
  • Impact analysis of the changes and regression testing

Enhance the System for Customer Requirement:

  • Impact analysis of the enhancement requirement on the current product functionality
  • Estimation and prioritization of the enhancements
  • Preparation of design documents
  • Development
  • System Testing and Regression Testing
  • Configuration management
  • Coordination of release

Re-engineer the background system:

  • Optimizing code for performance enhancements
  • Improving existing system features in terms of Usability
  • Database modeling using ERWIN

Documentation:

  • Preparation of technical documentation related to enhancements
  • Preparation of project plan for the enhancements release
  • Preparation of test plans, test cases and test reports

Improve the Process:

  • Discover and eliminate main causes of problems reported on product.
  • Analyze and improve the current maintenance plan

Migration Project:

Migration of existing product into newer technology dotnet and adding features which are current in the industry was the main objective of the project. The following are the highlights of the dotnet project.

  • Web based
  • N-tier architecture
  • Reusable application functionality blocks
  • Multiple document interface (MDI)
          - Windows reside under single window
  • Deployment based on MSI installer
  • Rich user interface - using infragistics controls
  • Supports globalization and localization
  • Single sign on
  • Database SQL Server 2005
  • Dotnet framework 3.0
  • Loosely coupled new modules workflow, document management
  • Ajax implementation

Benefits:

  • A dedicated team in place for all future development requirements thereby enhancing the customer satisfaction as required.
  • The onsite team can concentrate on the support, product management and gather the customer needs.
  • The product can be made competitive with able support of development team to the marketing team.

Technology:

OS Windows Server 2000, Windows Server 2003, NT and XP
IDE MS Visual Studio 6.0, Visual C++
Front end Gupta version 3.1 ptf 3, ASP.NET/IIS, VB.Net
Mapping Tool Sybase EC-Map, FREDI
Reporting Tool Crystal Reports 8.0, 11
Middle Ware COM+, XML, XSL
Database MS SQL Server Version 7, 2000 and 2005