Helping the Insurance Industry Meet Changing Market Dynamics Cost Effectively and Collaboratively

Custom Software that Enables Faster Claims Processing, Improved Customer Experience

The Challenge:

The insurance industry must address continuous regulatory scrutiny, as well as new and complex compliance requirements and changing rules, while grappling with the need to justify rising costs and provide personalized service to customers.

Particularly in the healthcare insurance industry, insurers must work closely with providers and patients to encourage healthier patients and improved outcomes through greater collaboration and by playing a more active role in encouraging preventative measures. They also understand that today’s customers demand a better user experience than in the past, with instant answers to their questions and knowledgeable claims representatives who understand their specific needs.

At Wovenware we understand these needs and provide custom solutions that are helping leading insurance firms rise above them, offering:

  • Interfaces and integration with internal and external systems
  • Web Portals
  • AI-based Analytics Solutions
  • Chatbots

Our Approach:

We work closely with you to design solutions that meet your specific needs, leveraging best practices gleaned from our work with leading insurance providers. For example, 
We design e-commerce portals through which insurance providers can invoice customers, and customers can view their invoices, reconcile them, or make changes, such as adding or removing members.

We also provide integrations with other systems to enable greater visibility, as well as reporting and data sharing capabilities that comply with ASC X12, ACORD and HL7 international standards.

For example, for one client, Triple S Advantage Solutions, an independent licensee of Blue Cross and Blue Shield in Puerto Rico, we developed an integrated system using our Integrator solution to convert data into the right format to be compliant with the Medicaid Management Information System (MMIS). This electronic data exchange (EDI) solution manages claims data internally and also connects to a dozen external systems operated by outside providers and drug stores. The solution helps the company determine claims and Medicare eligibility, while also processing payment information and tackling other tasks. Thanks to the solution, the company is able to have one employee processing claims from 120,000 members.

And innovative AI-based chatbots are significantly transforming the industry, empowering agents, brokers and customer service representatives to enhance the customer experience with automated personalized services, faster claims handling and individual risk-based underwriting processes.

For insurers like you, the future of claims processing is now, and we’re here to help you get up to speed.

We work with you to understand your needs