Payer
Healthcare Insurance
Technology
Azure Integration Account
Azure Logic Apps
Key Outcomes
Benefit enrollment automation significantly reduced processing time and accuracy
Improved data consistency across partner submissions
VNB Health partnered with a leading health insurance provider to streamline and automate benefit enrollment processes, eliminating inefficiencies and reducing errors.
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 leading health insurance provider, serving a diverse clientele, including employers, individuals, and families. Known for its commitment to excellence and innovation, the company focuses on delivering seamless benefit enrollment experiences.
Customer Situation
Managing benefit enrollment files from multiple partners was becoming increasingly complex for the insurance provider. The process was slow, prone to errors, and required significant manual effort. Inconsistencies in data formats led to processing delays, creating bottlenecks that affected timely enrollment and customer satisfaction. The company needed a streamlined approach to efficiently handle enrollment files and ensure accuracy across all partner submissions.
VNB Solution
Understanding the challenges, VNB Health helped the insurance provider implement a structured and automated approach to benefit enrollment. By eliminating manual inefficiencies and automating key steps, we enabled smooth and accurate processing of enrollment files from multiple sources. Our approach established a clear, standardized workflow that improved data consistency, reduced processing delays, and ensured compliance with enrollment requirements. As a result, the customer achieved seamless benefit enrollment automation, minimizing errors and enhancing the overall experience for employees, partners, and beneficiaries.
Customer Benefits
- Faster Benefit Enrollment Processing – The new benefits enrollment automation approach significantly reduced processing time, allowing benefit enrollments to be completed quickly and accurately.
- Reduced Errors – Eliminating manual interventions minimized discrepancies and improved data consistency across all partner submissions.
- Seamless Partner Collaboration – A structured process allowed the customer to integrate enrollment data from multiple partners effortlessly, ensuring smooth operations.
- Enhanced Visibility – The customer gained better oversight of the benefit enrollment process, making it easier to track and address any issues promptly.