Health Insurance Software to Streamline Injury Management and Recovery
About Our Client
The Client is a US company offering caregiver and patient services related to vehicle claims, such as handling loss evaluations for injured patients by licensed health professionals and routing patients to specialty care physicians in compliance with their health plans.
Challenge
In any injury case, managing personalized treatment and recovery is a troublesome and lengthy process that requires the seamless cooperation of multiple parties at every claim settlement step, from FNOL registration to payouts. The Client wanted to implement a solution that would facilitate and streamline the process. At the first stage of the project, the Client turned to ScienceSoft’s health insurance software development experts for conceptualizing the future solution and creating a detailed requirements specification.
Solution
The concept created by our health insurance IT consultants includes three types of system users: caregivers, law firms, and insurance companies. The solution allows for streamlined cooperation between three parties and minimized claim settlement delays.
How the system works
Within the system concept, each party will be able to track the case progress and update the information on injuries, treatment, medical bills and claims.
While caregivers will create treatment plans and monitor patient recovery, they will have access to the related system functionality, including patient personal information, insurance information, lab results and injury photos.
Law firms, in turn, advise the injured parties on legal issues, assist in insurance coverage and ensure the appropriate compensation for injuries. Therefore, the legal party will access the functionality focused on bills, claims and documentation.
Insurance companies will access the features related to FNOL registering, claim processing, and loss adjustment.
By ensuring transparent multi-party collaboration, the solution serves as a tool to facilitate and improve cross-organizational communication, easily organize case processing workflows, and cut on time for claim settlement.
Results
The system concept along with the requirements specification created by ScienceSoft’s team let the Client confidently plan its collaborative solution for caregivers, law firms, and insurance carriers to seamlessly handle vehicle accident injury cases. Currently, our team is involved in designing the architecture and technology stack for the system.
