Case Studies

Business Process Automation for a Health Insurance Litigation Company

Client Overview

The client is a leading consulting firm specializing in health insurance litigation that helps providers and patients resolve disputes with or without help of law firms.

Icon for Challenge

The Challenge

Over the years, the client has developed proprietary rules and methodology to develop fair pricing terms for services provided by physicians or hospitals.  The process was highly manual and limited the number of such cases that can be handled at a given time.

Icon for Challenge

The Solution

Amazech was contracted to provide a turnkey solution that provided unified data management, workflow and core business processes into a secure, scalable and modular Microsoft Azure-based solution.

Some of the key capabilities we built include

  • Active Directory-based authentication
  • Master Data Management
  • Client Management
  • Provider and Physician Management
  • Rules Engine containing proprietary rules
  • Detailed and summarized document generation
  • Generate calculation sheets and charts
  • Process files totalling over 5 billion rows from CMS

Our Process

Amazech conducted requirements study and planned, architected and implemented these in an incremental manner using Agile methodologies. Microsoft DevOps was used to define and track Epics/Features/Stories.  Apart from daily stand-up meetings and bi-weekly sprints, there was constant client engagement throughout the project via weekly product backlog reviews and demos of the completed work. The solution helped streamline the client’s business and scale up operations, resulting in high operational efficiency.

Diagram of the Business Process Automation for a Health Insurance Litigation Company

Icon for Challenge

The Results

  • Quick turnaround of cases
  • Better management and disbursement of claims
  • Improved client satisfaction
  • Higher pricing accuracy
  • Ability to scale operations
  • New opportunities to analyze data and produce quality reports
  • Ability to quickly change and adhere to new standards
  • Ability to grow into more states
Icon for Challenge

Customers Say

The programming needs for our application were highly technical. The Amazech team was up for the task! They have an organized system in place that simplifies the entire development process. They will dive deep into your business in order to produce a secure, user friendly, scalable product to your specifications. Their friendly, professional and helpful approach made the whole process enjoyable. With very competitive prices and a high level of competency, we recommend Amazech without hesitation.

Daphney Elliott Chapman Consulting LLC

Other Case Studies