success/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

Telemedicine Health Insurance Provider:

Telemedicine Health Insurance Provider:

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

Industry: Healthcare & Life Sciences

Delivery Center: South America, Mexico, and Costa Rica

Industry Context (2)-Oct-29-2024-06-26-56-3701-AM

Industry Context

The health insurance industry faces challenges due to exponential growth and dynamic consumer demands. Relying on outdated systems, insurers often struggle with inefficient processes for provider onboarding, claims management, and customer interactions. They constantly seek innovative tech solutions for streamlining their operations to improve service delivery, reduce costs, and ensure compliance.

Client Challenge

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 faced significant operational hurdles due to rapid expansion. Their reliance on a patchwork of outdated software led to inefficiencies in critical processes like provider onboarding and claims management, which hindered service delivery and customer satisfaction. To overcome these challenges, the client needed a flexible technology framework that would not only address the immediate challenges but also adapt to evolving market dynamics, legal regulations, and changing business practices.

Approach

Encora selected Appian as the platform of choice due to its rapid application development capabilities and flexibility, enabling streamlined workflows to meet the client's complex operational needs. Additionally, Appian's robust integration features support seamless connections across various systems, enhancing the overall efficiency of the health insurance provider's processes.

  • Product Management:
    • Managed strategic planning and prioritized features, enhancements, and updates for the Appian platform
    • Developed product roadmaps for automating business processes with Appian
    • Visualized and communicated design concepts, oversaw development, and provided ongoing support
  •  Product Development:
    • Architected and developed an Appian-based low-code platform as the core of applications infrastructure to facilitate process automation
    • Created visual interfaces and pre-built modules, including a set of pre-built components such as templates, drag-and-drop interfaces, and pre-built workflows
  • Data Architecture: 
    • Developed data models and Appian Sync Record Models to support the process automation application, ensuring effective data management and integration
  • CX Transformation:
    • Accelerated rapid application development and implemented end-to-end process automation, enhancing customer experience through optimized customer-facing processes
    • Facilitated digital transformation with a flexible, scalable, and agile platform for application development and deployment, automating workflows through AI Doc Extraction, integrating DocuSign, and implementing business logic
    • Integrated multiple systems to address different needs and data formats, creating a seamless platform for stakeholder interactions
  • Application & Product Maintenance:
    • Delivered product support and maintenance to ensure stability and ongoing functionality, addressing issues proactively to minimize disruption
  • DevSecOps Strategy & Planning:
    • Enhanced the DevOps process and reduced the risk of errors with Appian’s Compare and Deploy feature, streamlining deployment and improving code quality
  • Test Strategy & Planning:
    • Established a comprehensive testing framework, including unit testing, performance testing, and user acceptance testing, utilizing Appian’s built-in testing capabilities to ensure high-quality application releases
  • Digital Transformation:
    • Facilitated digital transformation with a flexible, scalable, and agile platform for application development and deployment, accelerating time-to-value for clients
    • Automated workflows through AI Doc Extraction, integrated DocuSign, and implemented business logic
    • Integrated multiple systems to address different needs and data formats, creating a seamless platform for stakeholder interactions
    • Improved the overall customer experience through robust user interfaces and optimized processes

Appian Services

Designer

Process Automation

AI

Integration Services

Data Fabric

Results

By transitioning to a more predictable license model with Appian, the client achieved significant cost savings, enhanced budgeting capabilities, and streamlined operations. The new platform enabled rapid application development and empowered departmental teams to manage their processes independently. 

  • Reduced management complexities associated with legacy software by transitioning to a predictable license model
  • Enabled easy provisioning and de-provisioning of licenses through centralized access with single sign-on via Active Directory integration 
  • Enhanced system relevance and responsiveness by empowering departmental teams to configure interfaces, processes, and data requirements
  • Saved time through the utilization of a centralized Appian application that covers end-to-end processes
  • Achieved further savings through automated validation using AI Doc Extraction, integrated DocuSign, and optimized business logic

Time Saved

Time Saved

Cost Reduction

Cost Reduction

With Encora, you benefit from our broad experience in developing cloud-first, data-first, and AI-first solutions, crafted to optimize your technology investment for today and the future.

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Santa Clara, CA

+1 669-236-2674

letstalk@encora.com

Innovation Acceleration

Get the most from Appian when you work with Encora

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Santa Clara, CA

Innovation Acceleration