Client Overview

Client is a US based optical dispensing and claim management service provider, delivering the speed, efficiency and connectivity of the Internet to all participants in the eye care industry – enhancing their productivity and profitability with a single resource to serve their informational, educational and commercial needs.

Business Challenge

The client was looking for an offshore vendor for setting up an Offshore Development Centre. It posed the following challenges:

• Strict delivery timeframes required by the client

• Quick turnaround time for migrating to .NET from Salesforce

• Small time frame to ramp up on the new skillset i.e. extJS

• Global delivery model to maintain a single code base across the world

• The client management wanted to leverage the offshore services based model to build an extended team to assist in:

1. Product development

2. Support & maintenance

3. Enterprise services

• Product development needed to be compliant with HIPAA norms

• Co-ordination between multiple onsite, offsite and offshore teams

Technical Requirements

Solution Strategy

• Offshore-based center to manage complete operations

• Product Development: Development of highly complex, core areas of product using Agile methodology, comprising following modules:

1. Claims: This module is developed to:

• Submit and track claims

• Search submitted claims

• View, edit and print claim forms with CMS-1500 background and without background

• Generate electronic receipt of remittance advice

2. Products: This module is developed for eye care related products to:

• Access prescriptions from different tabs like Home tab, Patient tab and Products tab

• Place an order from the patient’s prescription and order history

• Maintain history of patient orders, order status and orders inventory

3. Scheduler: This module is developed to:

• Schedule patient appointments

• Update, remove and edit appointments to different type slots and different resources

• Request appointments on the patient portal from Facebook for new and existing patients

• Send email, SMS and voice notifications about appointment update

4. POS: The Point of Sale (POS) module would be used to process patients after they have completed checkup or other appointments. For e.g. Optical to fill newly issued prescriptions, invoice generation and payment for today’s products and services etc.

5. Benefit: This module is developed to:

• Cater to the benefits or loyalty aspects of the system

• Manually enter eligibility and authorization information received from the clients and medical insurances via website, phone, or fax

• Upload documents that contain eligibility and authorization details

• View and link benefit details of specific patient appointments

• Print, copy or change status of selected benefit details

6. Admin: This module is developed to:

• Manage user roles and access permissions

• Setup locations, facilities, providers, products, services, inventories, RX orders, claims, invoices, devices, referring providers, outbound messages, patient portal, revenue and commission in the system

• Enterprise Services: Eternus Solutions team understands the complexity of installed products, business and environment and has delivered product customization and enhancements within the desired timelines.

• Support & Maintenance: Eternus Solutions team supported all live issues faced by the customers in the existing product implementations and provided resolution to complex and critical issues within SLA time.