Telemedicine Health Insurance Provider: Developing a low-code platform to streamline operations and automate workflows

Telemedicine Health Insurance Provider:

Developing a Low-code Platform to Streamline Operations and Automate Workflows

Industry: Healthcare & Life Sciences

Delivery Centers: South America, Mexico, and Costa Rica

Developing a Low-code Platform to Streamline Operations and Automate Workflows

Industry: Healthcare & Life Sciences

Delivery Centers: South America, Mexico, and Costa Rica

Industry Context

Low code solutions in healthcare are accelerating innovation and driving digital transformation. Low code platforms allow healthcare organizations to quickly develop and deploy applications using pre-built software components.

Appian is a well-known low code platform used in the healthcare industry. Organizations can easily and quickly design and deploy custom applications, thanks to the tools and services offered by Appian. With the help of Appian, healthcare organizations can develop custom applications that manage patient data, simplify administrative procedures, reduce costs, and enhance patient outcomes.

Client Challenge

The client is a health insurance company headquartered in New York, specializing in telemedicine, healthcare focused technological interfaces, and transparent claims pricing systems.

The client has experienced rapid, exponential development, which required its IT infrastructure to stay up to date. Yet, the business had to rely on a patchwork of software due to the quick expansion. Key business operations, like provider onboarding and claims management, were handled using software that wasn't designed to handle such intricate procedures. Instead of being a source of empowerment, technology had become the client's Achilles heel.

The client required a technology framework that could not only correct the issue at hand but also be adaptable enough to consider shifting market dynamics, legal requirements, and business practices.

Approach

Strategic planning and prioritization of features, enhancements, and updates for the Appian platform, Technology Evaluation of the existing system and Product Roadmapping for automating the business processes with Appian
Appian-based low-code Platform Development as the core of applications infrastructure to facilitate
Process Automation. Developed Visual interfaces and pre-built modules, a set of pre-built components, such as templates, drag-and-drop interfaces, and pre-built workflows
Automation of workflows through Auto Validation using AI Doc Extraction, DocuSign Integration, and Business Logic implementation
Digital Transformation with a flexible, scalable, and agile platform for application development and deployment accelerated the time-to-value for the client
Integration with multiple systems to process different needs, data formats, and stakeholder checkpoints from different departments into one seamless platform
Robust User Interface and Automation and Optimization of customer-facing processes improved the overall customer experience and engagement

Why Appian?

Speed – Appian applications can be built and deployed faster than the traditional methods
Scalability – Appian applications can be easily modified and updated to accommodate new requirements
Flexibility – Appian enables creation of custom applications for every business need
Integration – Appian allows integration of existing systems and data sources, making it easier to manage complex workflows and processes
Security – Appian offers robust authentication and access controls for protection from unauthorized access and data breaches
Collaboration – Appian's built-in collaboration tool allows multiple users to collaborate to build applications more efficiently, improving productivity and reducing the risk of errors

Appian Solution

The client's business had experienced rapid, exponential development, yet it had to rely on a patchwork of software due to the quick expansion
The current legacy software couldn't handle the key business operations. So, the client required a technology framework that could not only correct the issue at hand but also be adaptable enough to consider shifting market dynamics
Encora partnered with the client for Technology Evaluation of the existing system and creating a product Roadmap for automating the process with Appian's low-code platform as a consideration
The platform empowered departmental teams to configure the interface, process, and define the required data, making the system highly effective, relevant, flexible, and responsive without relying on specialized IT teams
Encora delivered a highly configurable application where the admins have great control to create and update their case flows using easy to use guided UI and users had focused user experience to work on this flows

Primary Appian Services/Features: Design, Process Automation, Integration, Data Fabric, Appian AI

Results

By moving to a more predictable license model from Appian, the client was able to save costs and better plan its budgets by doing away with a difficult-to-manage license model of the latter legacy software

The client could also provide a single sign-on across all services by integrating with its Active Directory. Power users can provision and de-provision licenses in the backend with a single click
The platform also empowers departmental teams to configure the interface, process, and define the required data, making the system highly effective, relevant, flexible, and responsive without relying on specialized IT teams. Appian enabled custom application development rapidly, for the changing market demands
There was 37% time saved for all the teams as they now work through a centralized Appian application to cover end-to-end processes
67% cost reduction due to Auto Validation using AI Doc Extraction, DocuSign Integration, and Business Logic