About the Client

The client delivers supplemental benefits for planned medical procedures to Self-Insured Employers. Their dedicated care coordinators offer full-concierge service to covered members, assisting them with selecting physicians, scheduling appointments, transferring medical records, coordinating logistics and following up post-procedure, reducing unnecessary stress and improving the member experience.

Business Challenge

As their business kept expanding, the client felt the need for an online member portal allowing customers to access their benefits information, search for providers and pay the deductible amount online. The portal would have to provide location based search to find out nearest provider and compare providers for the members.

This would help the client expand its user base and keep the business in tune with the always on-line, digital offerings that customers have come to expect.

The portal would have the following functionality:

  • Ability for customers to Compare providers based on ratings and view pricing and other pros / cons for each provider
  • Store favourite provider in a “My Favourites” section
  • Enable the client to administer health care surveys to customers

Silicus Solution

The application was developed to add and maintain benefits data for each of the client’s employers and to search, view, maintain and compare provider details. The application was designed to be HIPAA compliant. Silicus adopted a multi-tenant architectural design approach with a responsive user interface.

The application is to be accessed by Members (Employees of Client organization), Care Coordinators & Super Admin. It consisted of three main interfaces:

  • Member / Employee Interface
  • Care Coordinator Interface
  • Super Admin Interface

The portal helped the client to integrate disparate provider data in a centralized, transactional repository that allowed effective provider information management and automated interfaces with other systems (claims payment, provider reporting etc.)

The care co-ordinator interface helped members with the following functionality:

  • Provider selection as per requirements
  • Appointment scheduling
  • Facilitate transfer for medical records
  • Manage follow-up care instructions from the medical provider
  • Manage member’s out-of-pocket payments

Real time Management reports were created using Microsoft RDLC reporting tool, with Excel, PDF download options. Using a geo location feature, the portal enabled the care co-ordinators to located nearby providers with filters to zero in as per member requirements.

Our experts used .NET MVC / MS SQL for development and Azure for cloud hosting. The application front end was developed using a modern UI approach that leveraged HTML5, Bootstrap, JQuery, and JavaScript.

The application was deployed on Microsoft’s Azure IaaS cloud with the benefits of “pay-as-you-go” and Microsoft SLA’s on application uptime. The model would also allow the application to scale up and scale out as business grew.

Technologies Used

Language ASP.NET MVC4
Language

HTML5, AJAX, jQuery, C#

Platform
Platform

ASP.NET MVC, CSS 3, Bootstrap

Framework
Framework

Entity Framework 6.0

Database
Database

SQL Server

Hosting
Hosting

Azure IaaS

Client Benefits

Improved Customer Experience

The web interface formed a centralized location for care co-ordinators to interact with members through chat and helped them understand benefit plan information, view member profiles and submit cases for the members. Their assistance also helped members to drastically reduce the burden of Out of pocket payments.

Better Features & Services

Using the geo location feature, the portal allowed for a location based search to locate and compare nearby providers. The portal also helped employees to generate view and download management level reports for their reference.

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