Prashant Dobhal Email & Phone Number

Maharashtra, India

Pune/Pimpri-Chinchwad Area

Pune, Maharashtra

Client: SunLifeDomain: Health Insurance Area: ClaimsClaimFacts is a claims adjudication and payment system developed by Trizetto. It can handle medical, disability and dental claims. It provides an excellent online system for retrieval of policy and claims data in addition to the interface for claims administration. The system is designed to adjudicate all the claims that are fed to the system through online and daily batch cycle. The output of batch cycle consists of payments, correspondence (EOB, Prompt Pay letters, Pre-treat letters etc.) and reports. Claims that fail to pass batch adjudication are adjudicated online later by users for adjudication.

Pune, Maharashtra, India

Client: StateFarm Insurance Domain: Auto Insurance Area: Quote & PurchaseBAF (Business Application Framework) is a combination of three separate frameworks which includes DDUI, Request framework & PMMT along with their Integration Services for product and request data. A Request is a collection of business information needed to complete a transaction that creates or modifies an agreement. It captures the real data from the request that the customer or agent is making. The Request framework is what creates the request at run time from the spec. It manages or enforces all the business rules that are with that product. PL/1 Request Framework is a “Black box” that integrates between the business application and the product and request data. It can be used by any line of business and any business application. Request Framework Components allow actual requests (i.e., business transactions) to be made using the product specifications captured in the model and Request framework is the key in supporting business process functionality.