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