EmblemHealth Business Challenge
EmblemHealth, the largest health insurer in New York State, was required to modify a large number of applications for the implementation of new electronic coding standards for medical procedures. This created an immediate need to expand their testing capabilities beyond their current capacity.
Sharp Decisions' Solution
A Sharp Decisions V.E.T.S. QA team was engaged to supplement the existing client QA team and was given the specific responsibility for testing provider and incoming claim EDI transactions, as well as claim comparative testing. Accomplishing this required Requirements Analysis, Data Set Creation, Test Case Design and Execution, Root Cause Analysis, and Reporting. By collaborating closely with the Business Development, QA, and Operations teams, the V.E.T.S. team was able to complete testing on the projects in time for the organization to meet its deployment schedules. The training that Sharp Decisions provided as part of their V.E.T.S. Program was a major contributor to the success, preparing the Sharp Decisions QA analysts for application of customized SDLC used by the client and to quickly learn the operation of their back-end system.
The client benefited the V.E.T.S. efforts through the successful roll out of ICD-10 Claim processing applications without disruption to their business flow. Specifically, in the Quality Assurance area, Sharp Decisions has contributed in the following: extensive testing against both the front end and reporting applications, including defect tracking, test case execution and regression testing.