Business Challenge

Unreliability of the Electronic Gateway System for Claims Submission was leading to lost transactions, delayed responses, and an inefficient customer support organization resulting in poor customer service for Healthcare Service Providers.

Solution

RSI developed an Electronic Gateway System to replace the existing functionality. This solution addressed user population of about 25,000 dealing with over 56 million transactions annually.

Web based access for Provider’s claims submission, eligibility requests, and reporting.
• Role based secured login for Providers.
• Archiving utility to improve performance.
• Improved user experience with better Menu options.
• Technology Platforms:
   - BM AIX
   - Network Express, NXM

Results

BCBS has been very pleased with the results. As a result of this project another web-based portal project was awarded to RSI.

BCBS has experienced the following benefits:
• Improved customer service levels.
• More efficient handling of transactions.