REST API to EDI Connector Case Study

Overview

Our demanding customer experience era sets novel standards for businesses. We should follow its high level of accuracy, speed, and multichannel availability. As for the healthcare industry, it is vital to help professionals to concentrate on medical assistance by delegating a substantial amount of business workflows to powerful software solutions.

The turnkey project of our client is an exquisite combination of the best proven traditional medicare approaches and advantageous innovative integration, business automation, and 24/7 support.

In our REST API to EDI integration connector case study, you will get a comprehensive view of one of the essential modules we delivered for this enormously productive and important project.

‍

Business Challenge

The client required an advanced software solution — a connector for stable integration and data streamlining with insurance companies for its healthcare business project.

Before the company turned to CleverDev Software, it had to rely on the bulky approach to data exchange that was based on unintegrated multilayered workflows and involved a great deal of manual work and long waiting intervals on every level of information transportation.

The underlying incomplete data exchange method led to billing lags of up to three months and operation errors. The healthcare provider had to struggle with a substantial amount of non- or partly-paid claims, and couldn’t facilitate fast claim cycles to enhance the better responsive approach to answering the patients' requests. The incomplete data exchange solution was also a serious obstacle to audacious business development plans.

The only solution for the problem was implementing the X12 EDI standard that is mandatory for integration with insurance companies and clearinghouses.

Being developed back in 1979, an EDI is still a reliable method for data interchange. Meanwhile, it requires specific knowledge from experts that are not easy to find and rather expensive to hire. Things are radically different with the REST API format. It is among the most practical integration methods for modern software solutions and is a popular tech stack for the majority of software developers.

One more business challenge was in creating a consolidated feature for the set of applications used by our client. There was an urgent need of building a seamless ecosystem that could follow all strict security regulations for healthcare data interchange.

Because of these reasons, the company decided to increase its opportunities with a practical EDI to API integration connector for a smooth collaboration with insurance companies and clearinghouses. It should combine the best of both formats — accessibility, usability, and security of an EDI with simplicity, speed, and compatibility of an API.

Solution

Due to these reasons, our client made the right choice by using our superior custom software development capabilities. The team at CleverDev Software is competent in delivering healthcare software that meets excellence-demanding criteria. The perfect tech solution is what we always strive to create for our clients' businesses.

Therefore, we launched the REST API EDI integration connector building project to enable practical and powerful means of integration between a healthcare provider and insurance companies.

The CleverDev Software specialists delivered an integration connector that could receive protected REST API requests from our client’s software. Then the connector transforms the requests into EDI standard data based on X12 and transports them to insurers and clearinghouses. The response requests undergo the same transformation and transportation process in the opposite direction.

The connector is among the key elements of our client’s successful medicare business. It bridges EDI to API integration and helps connect traditional and reliable systems of file data formats that are tightly coupled with the insurance industry's core business with advanced data sharing capabilities through APIs.

In addition to the aforementioned essential features, CleverDev Software's team developed robust EDI to REST API connector’s functionality, including:

• Standardized B2B Network. It facilitates seamless streamlining of large quantities of patients’ data in a protected and regulatory-compliant electronic standard.
• Robust Security. The secure protocol for data exchange guarantees following the utmost privacy and security settings for the sensitive health and financial data of the patients. It provides a well-established relationship where only two parties can send and receive information and get full control over which data is sent right in their application.
• Accessibility and Ease of Use. Being an acknowledged industry standard, an EDI standard is the core of data integration with various partners from the insurance industry. Our connector simplifies the process of data transmission via a more efficient and easy-to-use REST API.
• Commitment to the Future. The connector builds the basis for future technology compatibility due to the API feature of anticipating new tech without any troubles.

We at CleverDev Software have an outstanding team of professionals with successful experiences and a deep understanding of healthcare, financial, and business automation.

To realize this project, we employed our unique and mature expertise full of twists and turns in EDI software delivery, the development of fully regulatory-compliant solutions, and cutting-edge tech approaches.

Due to this, we were able to guarantee our client fast and effective project delivery, as well as first-rate project performance.

Our client's business workflow was empowered with an API EDI integration connector in only six months. For this project, CleverDev assembled a dedicated team of four professionals.