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HSTC301

ELIGIBILITY RULES FOR INSURANCE ECOMMERCE PORTAL

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A Harbinger Systems Case Study

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ELIGIBILITY RULES FOR INSURANCE ECOMMERCE PORTAL

Situation

Challenge

A brick-and-mortar insurance company creating an eBusiness app to computerize eligibility workflow

Eligibility rules needed to be flexible and easily configurable Rules change frequently with time due to changing policies and regulations Rules implementation required automation with no programming

Harbinger Solution

Technologies & Tools

A binary-tree-based eligibility encoding proposed

Oracle RDBMS

Intermediate nodes were eligibility questions and terminating node were actions

Binary tree representation in RDBMS tables Component Object Model (COM)

Oracle RDBMS tables used to encode binary tree structure of eligibility workflow The largely static eligibility question nodes were encoded as DB stored procedures

COM component developed to run through encoded paths and fire questions to arrive at required action

BOTTOM LINE

Benefits Company encodes insurance eligibility workflow automation with noprogramming Frequent changes in eligibility can be incorporated within hours instead of days

HSTC301

www.harbinger-systems.com

Company implemented a complex workflow automation that required no programming and maximum flexibility to match frequent future changes

Eligibility Rules for Insurance e-Commerce Portal  

An e-Business application that computerizes eligibility workflow through a flexible, rule-based engine requiring no programming, this applic...

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