Healthcare Insurance Provider

The Client

This regional health insurance provider services approximately four million people and processes more than 25 million inquiries from clients, providers, and service vendors annually. The client's online services have grown dramatically, and with it the need to handle large volumes of data securely in compliance with HIPPA requirements. Services included Managed Care, Traditional Indemnity, Medicare, and Medicaid—each with a variety of plans, fee schedules, allowed or preferred vendors, deductibles, and co-payments. The system also supports all of the back office claim functions and traditional business processes.

The Engagement

Encode was asked to change everything about an existing web portal—except the "look and feel." This included integrating several separate portal systems into a single system so individual health insurance users, service providers, vendors, and corporate subscribers could access customized data, forms, and other information in a secure fashion.

Critical Services Delivered

Encode designed both the architecture and the framework of the portal. Encode programmed key framework components, developed a deployment schedule, and integrated the new portal systems into the existing mainframe applications and database. Encode was also able to support single sign-on implementation and create desktop environments for the project developers.

While addressing the initial challenge, Encode took on responsibilities in other areas as well, including the design and integration of security features, in-depth client mentoring, as well as generating exhaustive documentation for each component of the project.

• Architecture Design and Development
• Integration of New Systems Into Existing Mainframe and Database
• Implementation of Single Sign-On
• "Best Practices" Mentoring

Technology Used

Software used on the project included IBM WebSphere Portal and IBM MQ Series, to interact with the client's mainframe applications and data. Tivoli Cluster Monitoring, which allows monitoring of the state of a cluster and its components on a Tivoli Desktop window, will be added in the next project phase.