“Failure is NOT an Option”

Client: National HMO with over 5-Million members

Project

A national HMO needed to rewrite functionality from a defunct billing system that had been cannibalized and abandoned over the years. The age banded billing (billing based on member age) feature of their software had been dismantled at some time in the distant past.  None of the original programmers were still employed at the company and there was no documentation.

Solution

We re-enabled the functionality of the age banded feature and updated the related programs to suit the client’s particular needs. Because the client was an HMO with millions of customers, errors in billing would be devastating. We developed a strict software development life cycle (SDLC) and testing plan to ensure that when the software was put into production the process was seamless, efficient, and most importantly, error free as tens of millions of dollars was at stake each month.

Results

Reinstating the age banded feature allowed the client to bill their members based on their age, which better aligned their revenue versus costs and opened new markets for them.