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Digitalization of the paper-based process for writing expert opinions on long-term care requirements
Project duration: 4 months
Brief description
In private health insurance, MEDICPROOF is contracted by the insurance company to write expert opinions on long-term care requirements. To reduce the throughput times and meet legal requirements, a paper-driven process is being digitalized. It is implemented on the basis of an ESB (Enterprise Service Bus).
Supplement
The data is transferred to MEDICPROOF and the reports are collected via the IBM Integration Bus (IIB). Once the order has been received, the ESB collects all necessary data from the existing systems of the insurance company, transforms it and transfers it to MEDICPROOF. Furthermore, the ESB regularly calls up the reports that are ready for collection from MEDICPROOF and stores them in the existing systems of the insurance company.
Subject description
In the case of grading reports, the insurance company is obliged to provide notification of the decision regarding the application within five weeks of receipt of the complete application documents by mail. If the deadline is missed, the insurance company must pay penalties to the applicant for each week or fraction thereof. In order to meet this obligation, communication with MEDICPROOF which previously took place via fax in order to collect expert opinions on long-term care requirements is being converted to an automated process.
Overview
- Industries insurance
- Specialist tasks BPM: process realization, health insurance, interfaces
- DV tasks concept
- System environment Enterprise Application Integration (EAI)
- Procedure model iterative procedure
- Development/ test tools soapUI, XML Spy IDE
Project period27.08.2015 - 23.12.2015
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