US Healthcare Domain Training

Aster Health – Health plan selection management
Aster Health wants to enable a mobile application where individuals will be able to use it for enrolling in new plans, check their coverage and eligibility, Find Care and Costs and View Claims submitted. The healthcare payer wants to replace the existing manual member enrolment and inquiries, with an easy access online portal/mobile application. The company has signed a multi-year deal with TransTech Inc to develop and manage the new system.

Project Objectives: Create the process flow for the member to search and select health plans in order to consider for enrolling, if satisfied with health plans offered.

Daisy Hospitals – Member Eligibility Verification
Daisy Hospitals wants to enable a web application where the Provider or Provider’s office personals will be able to verify the eligibility of patients who book an appointment for an encounter with a Physician. The hospital expects to reduce the number of calls made to the Payer for verifying Patient’s eligibility. The company has signed a multi-year deal with eHealth Inc to develop and manage the eligibility verification system.

Project Objectives: Create the process flow for the Provider or Provider office personnel to submit the eligibility verification request.