One of Canada's largest niche market providers of travel and health insurance products.

The Company, through its subsidiary, also provides assistance, case management, cost containment and claims services. The Company in exploring new avenues for growth has identified claims repricing domain as a future growth driver.

Claims repricing (Claim repricing is the application of a fee schedule to a medical claim and is driven by the payor or healthcare plan administrator's need to access a healthcare network's contracted discount rates), in a manual scenario, would encompass faxing or mailing in a paper claim for repricing, manual entry into a claims processing system - the whole process thereby involving several layers of personnel leading to a spiraling operational cost and longer process times.

The Company requested Inteq to provide a solution to reprice claims electronically with minimum human intervention.

Since the requirements were not well established, Inteq proposed a two phased approach. The goal of the first phase was requirements gathering, analysis and high level design of the proposed system. Inteq business and technical analysts helped develop the requirement specifications and design of the proposed system christened 'e-Repricing'. On completion of first phase a fixed price estimate was provided along with a detailed schedule.

The second phase involved project execution. To help implement the phases, Inteq adopted its established on-shore/offshore delivery model. The on-shore work included first phase, acceptance testing, implementation and support activities.

The requirements as recommended at the end of first phase included a system to assist the Company to reprice claims using its own automated or manual provider contracts and also provide option to electronically exchange claims with other contracted networks that are capable of repricing claims. The system is to have inbuilt capabilities to route claims to an appropriate network and receive repriced information with minimal user interaction.

Inteq in discussion with the Company recommended the approach of having two IT building blocks which include an EAI platform and a web application. The web application, clients and networks are to be seamlessly integrated, utilizing an EAI platform.

Gentran Integration Suite (GIS) was used as the EAI platform to receive, format and track claims. This platform orchestrates and launches the various programs in the web application in order to perform the required business rules.

The web application implements the core business rules related to repricing and was built on a Microsoft development platform. The application exposes some of the core business rules as web services and provides user interfaces to ACCPAC accounting system and Cognos Document Management tool.