Medical TPA Healthcare Insurance | Case Study

Holistic Medical TPA app integrated web-scale platform, that takes care of your healthcare & health insurance needs

Medical TPA Healthcare Insurance Integrated Platform

ABOUT CUSTOMER

The customer is a leading Medical TPA in Asia Pacific region with HQ in UK. Along side Healthcare Insurance, the customer offers a wide range of healthcare services via it’s integrated web and mobile solutions. Listed in global stock exchanges, the customer wanted to integrate their different services into one integrated Core TPA Engine clubbed to diverse user channels viz. web, mobile and CRM.

Application Requirements

Customer requirement was to build a comprehensive business delivery integrated web-scale platform that enables it optimally manage it’s business functions. Primarily being a Medical TPA (Third Party Administrator), there are multiple business processes that require to work in tandem to deliver customer services on the go. Healthcare consumers are primary users who are offered various services via Optimal Health platform viz. healthcare tips, information, consultation services and related information, insurance services and coverage, to name a few
The integrated web-scale platform had requirements to build a robust web back-end and database that takes care of medical TPA service delivery with respect to back-end, a user friendly mobile front-end solution and an integrated CRM to manage customer services.

The Business Case Challenge

The project requirements encompassed different technology stacks being deployed independently while functioning in an integrated manner to seamlessly provide business functions of a Medical TPA. The customer / user facing solution happened to be mobility solution i.e. mobile applications on Android and iOS plus an eCart i.e. an eCommerce web portal. The 3rd sub-system of the platform required a robust CRM that takes care of configuration, user management, privileges management, content delivery, reports and business intelligence & customer service / ticket management system. The challenge was to ensure all these sub-systems are interacting real-time with each other and delivering business functionalities seamlessly.

OdiTek’s Solution

OdiTek built a custom set of web API libraries layer to overcome the connectivity challenge in synchronizing the front-end mobile apps and between the web back-end plus CRM Solution. The major hurdle of ensuring performance and high security because of exposure of several APIs are taken care of by utilizing standard libraries and modularizing the architecture. High availability and scalability are ensured using Tier-4 Cloud deployment and taking in use some of the most advanced deployment features available in cloud infrastructure. Security challenges are distinctly different for iOS, Android and web sub systems and are thoroughly grilled to support the platform required security measures.

For providing an integrated eCommerce functionalities and interoperability with CRM, architecture provisioned single source for configuration, user management, product management and order functions.

The solution also required to query and fetch information from a heterogenous TPA Core engine and then distribute the information across sub-systems to deliver as per customer device or application front-end. This had it’s intrinsic challenge to maintain data structure and processing overhead. To built the seamless interworking, architecture and design was visualized considering the max no of concurrent users, database handling capabilities well before the product platform construction phase. Thereby eliminating any processing or memory bottlenecks during the implementation phases.

At a Glance

The customer is a publicly listed company in the Alternative Investment Market of the London Stock Exchange, has operational presence and healthcare providers’ network in UK, China and all major South East Asian countries. It is principally involved in providing regional third party claims administration (“TPA”) services, emergency medical assistance facilitation services, healthcare management services and operating a state-of-the-art electronic healthcard network infrastructure to facilitate healthcare claims processing.

OdiTek, with the help of its app connectivity experts, iOS and Android app development team, and Web Platform developers created Optimal Health integrated platform solution to deliver TPA customer services in multiple delivery channels.

Industry

Medical TPA, Healthcare Insurance

Key Results

A platform solution that renders TPA services on the go, healthcare services and information for customers, insurance agents, HR managers, providers and operations. Successful deployment and usage of an integrated heterogenous sub systems catering needs to all stakeholders in the TPA business.

Technologies Used
  • Design: Bootstrap Responsive Design
  • OS: Linux, Android, iOS, Windows
  • Languages: Java, Objective C, PHP, .Net, Java Script, AngularJS, NodeJS
  • Database: SQL, MongoDB, MySQL, SQLite
  • Third Parties: Payment GWs, SMS GWs, Logistic APIs, Data Analytics Open Source Stacks
  • Deployment: Tier-4 Cloud

Mobile Solutions
CRM Solutions
eCommerce Solutions

HIGH LEVEL ARCHITECTURE

Result

The integrated platform development project took 8 months to deploy CRM Solution, Mobile Apps on Android & iOS & eCart web portal. All sub-systems were deployed which were perfectly working sealmessly with each other, providing all intended business functions in a centralized automated manner. With a month of deployment and system handover, entire customer support functions successfully migrated to the platform and TPA customer features are started being provisioned using the platform. The success of this project led to another similar project from the same Medical TPA industry.

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