Payer
Healthcare Insurance
Technology
Microsoft Azure DevOps
Key Outcomes
Improved system stability
Increased staff efficiency and reduced eligibility verification errors
A major healthcare insurance provider faced challenges in deploying middleware interface updates efficiently and reliably. To address these issues, VNB team implemented a specialized technology solution that enabled continuous integration and continuous delivery (CI/CD) pipelines with advanced testing capabilities.
Customer Profile
The customer is a prominent healthcare insurance provider serving a vast population. With a rich history in the industry, they are committed to delivering comprehensive healthcare solutions and enhancing member experiences. The organization operates in a highly regulated environment, necessitating robust and compliant systems. Due to the sheer volume of transactions and complex nature of healthcare data, the customer handles a significant workload, demanding efficient and reliable IT operations.
Customer Situation
The customer handled 270/271 Healthcare Eligibility Benefit Inquiry transactions to verify patient healthcare eligibility, coverage, and benefits. The customer relied on custom API interfaces built on Microsoft BizTalk Server to connect with multiple insurance payers. This complex integration environment, characterized by high transaction volumes and frequent changes, was prone to instability. Updates to one payer’s interface often disrupted connections with others. To mitigate this risk, accelerate development and ease the build, deployment and testing process, the customer sought an automated solution that would enable continuous integration and continuous delivery (CI/CD) with robust automated testing.
Customer Profile
The customer is a major healthcare insurance provider serving a broad population, offering comprehensive healthcare solutions while ensuring compliance with stringent industry regulations. They are committed to delivering accurate and timely services while managing high transaction volumes daily.
Customer Situation
The customer processed a large number of eligibility verification transactions daily to ensure patients received accurate information about their healthcare coverage and benefits. These transactions relied on custom-built interfaces to connect with multiple insurance payers. However, frequent updates to payer interfaces often caused unintended disruptions. As a result, delays, errors, and inefficiencies occurred in the verification process.
As payer requirements evolved, maintaining a stable and efficient system became increasingly difficult. Each update risked breaking existing connections, creating administrative burdens, delaying reimbursements, and disrupting patient care. The manual processes required to manage these changes were slow and labor-intensive, making timely and reliable eligibility confirmations a challenge.
To resolve these challenges, the customer needed a more streamlined approach. They sought a solution that would minimize disruptions, standardize updates, and improve overall system reliability. Reducing manual effort, enhancing accuracy, and creating a predictable workflow were top priorities.
VNB Solution
VNB Health worked closely with the customer to strengthen their healthcare interoperability strategy. Our team ensured seamless data exchange between their eligibility verification system and multiple payer interfaces. We introduced a structured, automated process that enabled secure, reliable, and efficient integration across disparate healthcare systems. By implementing industry best practices for healthcare data interoperability, we ensured smooth updates without affecting other payer connections.
Through workflow optimization, validation mechanisms, and reduced manual intervention, we helped the customer build a more resilient and predictable eligibility verification system. This new approach stabilized operations and provided a framework for continuous improvements. As a result, the customer could adapt more easily to future regulatory and operational changes while maintaining interoperability compliance.
Customer Benefits
- Improved System Stability: Updates to payer interfaces no longer caused disruptions, ensuring seamless eligibility verification while minimizing system downtime.
- Increased Efficiency: Automated processes enhanced healthcare interoperability, reducing manual work and allowing staff to focus on higher-value tasks. Additionally, response times for eligibility checks improved.
- Enhanced Accuracy: Standardized processes reduced errors in eligibility verification, ensuring patients received the correct benefit information.