Supporting health insurance digitalization with Integration Designers & IBM
The world of health insurance is currently undertaking one of the biggest digitalization efforts in its history. Health certificates, traditionally printed or written on paper, are rapidly becoming digitized, allowing the health insurance organizations to refund health costs within the day. This revolution requires a thorough digital integration of healthcare providers and insurance organization systems (which is brought about via MyCareNet). To assist them in this heroic endeavor, the national union of socialist health funds (NVSM-UNMS) found the perfect partner in IBM & Integration Designers.
Every Belgian citizen probably knows how the legacy system works: you visit the general practitioner, he/she gives you a medical statement on which you add your health fund sticker, you deposit it at your nearest health fund office and receive a repayment in your bank account. NVSM-UNMS offices used to pay the statements in cash making them an ideal target for numerous raids and burglaries. One of the reasons why they decided to make the shift to electronical payments. To speed up this process NVSM-UNMS offices now scans the health certificates but it still takes some time for the payment to appear in your bank account. However, many people don’t realize a lot of processing and checks need to be done in the time between handing in the certificates and receiving the payment.
To reduce both the time before repayment and the amount of manual processing required per certificate, the health insurance organizations decided to digitize the entire process. Easier said than done, because a lot of stakeholders are involved. It quickly became clear that the NVSM-UNMS needed a high quality, well documented Enterprise Application Integration (EAI) strategy to make things work.
Initial experiments quickly ran into performance issues, which is why NVSM-UNMS started looking for a platform that could meet their high performance, availability and security requirements. Because NVSM-UNMS was already running IBM systems they quickly arrived at IBM’s DataPower Gateway as a perfect fit for their needs.
“IBM’s DataPower Gateway allows us to quickly set up new integrations while ensuring that they are compliant with our standards,” Steve Bertjens, IT manager at NVSM-UNMS mentions, “and because DataPower appliances are completely optimized for the job, our performance issues are a thing of the past”
“We selected Integration Designers from a shortlist of possible integrators,” Steve states, “though we initially brought Integration Designers on board as part of a ‘firefighting’ mission, due to the success and useability of the solution we even had to scale up our cooperation to keep up with demand”
Integration Designers proved itself to be a reliable partner every step of the way. Functioning not only as platform experts, the integration designer engineers worked with NVSM-UNMS on both a technical and operational level. From the initial design phase to the maintenance and future expansion of the platform, Integration Designers provided NVSM-UNMS with the exact amount and type of expertise they required at the time.
In the end the accomplishments speak for themselves: starting from an initial mission to set up a first workable environment, Integration Designers has worked with NVSM-UNMS to set up a highly successful platform that is quickly becoming the backbone of their digitalization efforts.
Thanks to the flexibility and extensibility of the platform, new integrations are added all the time. For example, NVSM-UNMS is currently working on digital payment integration with IBM API connect – which integrates seamlessly with the DataPower runtime – allowing clients to settle bills in real-time simply by scanning a QR code.At NVSM-UNMS, the vision for digitalization is clear: reducing the amount of time spent on cumbersome manual processing allows NVSM-UNMS to focus on providing good service to their clients. Thanks to IBM technology and Integration Designers expertise, NVSM-UNMS possesses a flexible and powerful platform that fuels their digitalization ambitions
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