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Automating Claims and Payment Status Inquiries in Healthcare
Business Problem
The business problem in this case is related to the IBIS (Item Banking Information System) application, which interfaces with multiple other business applications. When those applications undergo changes or enhancements, the IBIS application also needs to be updated in order to continue functioning correctly. However, updating the IBIS application can be a complex and time-consuming process, as it requires modification of existing interface agreements with the other applications and transformation work to ensure continuity of the existing work while the new formats are being loaded into IBIS.
Additionally, there are customer-specific test formats that need to be uploaded into IBIS in order to conform to business standards. This creates a further challenge, as the new formats need to be loaded into IBIS in a way that doesn't disrupt the existing format processing.
The problem is that the current process of updating the IBIS application is time-consuming and complex, and it is hard to ensure continuity of the existing work while loading new formats. Moreover, loading new formats conforming to business standards without disrupting the existing format processing can be difficult. The company is facing challenges to keep the IBIS application updated and maintain the continuity of the existing work while the new formats are being loaded into IBIS.
Business Solution
The business solution in this case study involved addressing break fixes in the production environment for the IBIS (Item Banking Information System) application. The IBIS application interfaces with multiple other business applications, and when those applications undergo changes or enhancements, the IBIS application also needs to be updated in order to continue functioning correctly.
The main challenge in this case was that the existing functionality within the IBIS application needed to be upgraded to incorporate the changes posed by the other applications it interfaces with, while at the same time ensuring that existing interface agreements with those applications were modified to accommodate new and revised data fields.
Additionally, new customer-specific test formats were being added to IBIS as part of new business migrations. These new formats needed to be loaded into IBIS in a way that conformed to business standards, while also ensuring that the existing format processing wouldn't be impacted.
To address these challenges, the solution involved modifying and reusing existing utilities that perform the core IBIS functionality to assist with onboarding of the new customer formats. This way, the existing format processing could continue to function smoothly while the new formats were being loaded into the IBIS application. Overall, this solution allowed for a seamless integration of changes and new formats into the IBIS application, ensuring continuity of the existing work and minimizing disruptions to business operations.
Technical Solution
The technical solution for addressing the business problem in this case involves enhancing the current IBIS application code to accept the updated interface agreement with other applications. This will ensure that there is no change in the mode and delivery of data transmission with those interfaces, and appropriate business validation rules will be kicked off when data flows between the IBIS and other applications.
To ensure that the data is being transmitted correctly, utilities will be developed to ensure that the output XML data adheres to APIP Conformance standards and is validated against appropriate business XML schemas. Additionally, XML testing frameworks will be developed to ensure that changes in the XSL style sheets don't break the existing code. This will help to minimize disruptions to business operations and ensure continuity of the existing work.
To streamline the testing process, test automation will be enhanced by using Cucumber. This will include integration with Jenkins, which will help to simplify testing and reduce manual effort.
Furthermore, the solution will involve applying XSLT-based transformation to change the new incoming customer data format into an internal data format. This will ensure that the new formats are loaded into IBIS in a way that conforms to business standards, while also ensuring that the existing format processing doesn't get impacted.
Overall, this technical solution will allow for a seamless integration of changes and new formats into the IBIS application, ensuring continuity of the existing work and minimizing disruptions to business operations.
Technologies
The technologies used in this case study include Java, XML, SQL, PL/SQL, JavaScript, CSS, HTML, AJAX, JDBC, JMS, Web Services, REST, SOAP, J2EE, Altova XMLSpy, Xalan, Struts, LOG4J, Spring, Hibernate, Junit, Jenkins, XSD, XSL 1.0, XSL 2.0, XML Schemas, DTD and DOM. These technologies are used to enhance the IBIS application and enable it to handle the updated interface agreement with other applications, new customer-specific test formats, and ensure continuity of the existing work while the new formats are being loaded into the application. They also help in testing, integration, data communication, data manipulation and XML handling.
Customer Success Outcomes:
Smooth integration of changes and new formats into the IBIS application, ensuring continuity of the existing work and minimizing disruptions to business operations.
Improved data communication and integration between different parts of the IBIS application and other business applications, through the use of technologies such as Java, JDBC, JMS, Web Services, REST, SOAP.
Enhanced user experience through the use of front-end technologies such as JavaScript, CSS, HTML, and AJAX.
Improved data management and manipulation through the use of technologies such as XML, SQL, PL/SQL, XSD, XSL 1.0, XSL 2.0, XML Schemas, DTD and DOM.
Streamlined and efficient development process through the use of frameworks such as J2EE, Altova XMLSpy, Xalan, Struts, LOG4J, Spring, Hibernate, Junit and Jenkins
Improved scalability and performance through the use of J2EE as a platform.
Reduced development time and costs through the use of well-established programming languages, tools, and frameworks that are tailored to the needs of enterprise applications.
Improved testing and integration process through the use of Junit and Jenkins.
Better data security through proper validation and transformation of XML documents.
Improved application architecture and design through the use of Struts.
Overall, the customer was able to achieve a more productive and efficient business operation, as well as a better experience for end users.
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