Q3 integrated customer website & various databases and automated the reimbursement of claims using Tibco BusinessConnect.

Q3's global sourcing model gives the maximum benefit to customers in terms of cost savings, improved quality, access to highly talented professionals, flexibility of operations and reduced time to market.

Company Profile

The Client is a leading provider of health insurance policies and sells various types of health insurance policies.

Business Situation

The client needed to integrate the customer website, various databases and automate the reimbursement of claims. Before implementation of TIBCO, the client was having paper based reimbursement system, which was very time consuming. The client had a separate fraud management system; they needed to integrate this system with the reimbursement process.

Solution

Q3’s Enterprise Application Team did the analysis and suggested the TIBCO BusinessConnect. Transfer of real time data from various databases and application has been enabled. The applications of claim reimbursement have been integrated with TIBCO infrastructure. Team Q3 integrated its fraud management system with this system. Enterprise Service Bus has been created for reusing the services; document processing has been done with the help of File Transfer tools.

Technology Used

• TIBCO B2B Integration with various components, like TIBCO GI for message monitoring.
• ActiveMatrix BusinessWorks has been used for application integration, services creation and orchestration. BusinessWorks provides proven scalability and reliability.
• ActiveMatrix Service Bus has been used as ESB (Enterprise Service Bus), this bridges the gap of SOA infrastructure.
• Files related to insurance claims were moving to appropriate department by using Managed File Transfer. It facilitates secure document exchange and automation of document processing.

Q3 achieved secure, inter-company exchange of business documents and automation processes by using TIBCO

BusinessConnect. BusinessConnect supports all major business and transport protocol and has smart routing and XML support.

Benefits

• Various claim processing has been integrated.
• Claim reimbursement processing became fast leading to more satisfied customers.
• Many fold growth in fraud detection.
• Process became less labor-intensive.
• Better tracking of claims.
• Greater security and efficiency in document processing.