{"id":3696,"date":"2024-05-21T23:10:37","date_gmt":"2024-05-21T17:40:37","guid":{"rendered":"https:\/\/www.healthasyst.com\/healthcare-it-services\/?p=3696"},"modified":"2025-09-16T18:07:44","modified_gmt":"2025-09-16T12:37:44","slug":"case-study-building-a-claims-processing-system-for-a-compounding-management-player","status":"publish","type":"post","link":"https:\/\/www.healthasyst.com\/healthcare-it-services\/case-study-building-a-claims-processing-system-for-a-compounding-management-player\/","title":{"rendered":"[Case Study] Building a Claims Processing System for a Compounding Management Player in 90 days"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"3696\" class=\"elementor elementor-3696\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section data-marvy_enable_drop_animation=\"false\" data-marvy_enable_fancy_rotate=\"false\" data-marvy_enable_flying_object=\"false\" data-marvy_enable_ripples_animation=\"false\" data-marvy_enable_waves_animation=\"false\" data-marvy_enable_rings_animation=\"false\" data-marvy_enable_topology_animation=\"false\" data-marvy_enable_gradient_animation=\"false\" data-marvy_enable_snow_animation=\"false\" data-marvy_enable_firework_animation=\"false\" data-marvy_enable_cloud_animation=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-2f6063b7 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"2f6063b7\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4d276f91 exad-glass-effect-no exad-sticky-section-no\" data-id=\"4d276f91\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-466d1459 wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"466d1459\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The customer is an independent compounding management company. They deliver solutions to the marketplace based on quality and fair pricing mechanisms. They settle pharmacy claims by working with Clearinghouses and the Pharmacy Benefit Manager (PBM).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section data-marvy_enable_drop_animation=\"false\" data-marvy_enable_fancy_rotate=\"false\" data-marvy_enable_flying_object=\"false\" data-marvy_enable_ripples_animation=\"false\" data-marvy_enable_waves_animation=\"false\" data-marvy_enable_rings_animation=\"false\" data-marvy_enable_topology_animation=\"false\" data-marvy_enable_gradient_animation=\"false\" data-marvy_enable_snow_animation=\"false\" data-marvy_enable_firework_animation=\"false\" data-marvy_enable_cloud_animation=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-2668126e elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-glass-effect-no exad-sticky-section-no\" data-id=\"2668126e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-60507908 exad-glass-effect-no exad-sticky-section-no\" data-id=\"60507908\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3ddabf2d wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"3ddabf2d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">The Need<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-271edf87 wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"271edf87\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>To build a fraud prevention solution for the customer from scratch within 90 days.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9e3ab84 elementor-widget-divider--view-line exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-divider\" data-id=\"9e3ab84\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f3e3642 wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"f3e3642\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">The Challenge<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-080410f wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"080410f\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The customer&#8217;s existing fraud prevention solution was built by another vendor. But the customer faced an unexpected 100% cost escalation. The escalation was due to an oversight regarding intellectual property rights.<\/p><p>The customer had no option but to embark on an arduous &#8216;Mission Impossible&#8217;- style task: <strong>Build an enhanced solution with even better features and functionality in 90 days before the previous contract was up for renewal.<\/strong> <br \/><br \/>Undertaking this task was the only way to avoid perpetually paying licensing fees.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-33171bbc exad-glass-effect-no exad-sticky-section-no\" data-id=\"33171bbc\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7f6edef4 wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"7f6edef4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Get it now<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-189000ae wcf-starter-animations-none exad-sticky-section-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"189000ae\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wcf_starter_animations&quot;:&quot;none&quot;,&quot;wcf_anim_duration&quot;:1000,&quot;wcf_anim_delay&quot;:0,&quot;wcf_anim_ease&quot;:&quot;ease&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f3703-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"3703\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/healthcare-it-services\/wp-json\/wp\/v2\/posts\/3696#wpcf7-f3703-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"3703\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" 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aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>The customer is an independent compounding management company. They deliver solutions to the marketplace based on quality and fair pricing mechanisms. They settle pharmacy claims by working with Clearinghouses and the Pharmacy Benefit Manager (PBM). The Need To build a fraud prevention solution for the customer from scratch within 90 days. The Challenge The customer&#8217;s [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":3700,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[4,5],"tags":[],"ppma_author":[139],"class_list":["post-3696","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-case-study","category-featured","entry","has-media"],"acf":[],"authors":[{"term_id":139,"user_id":16,"is_guest":0,"slug":"ha-pavan","display_name":"Pavan Bhatia","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/497dad1b19dee75a3ae92c93b219375156e21ec8229a6d8e1fe54965d4585254?s=96&d=mm&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/posts\/3696","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/comments?post=3696"}],"version-history":[{"count":12,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/posts\/3696\/revisions"}],"predecessor-version":[{"id":7347,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/posts\/3696\/revisions\/7347"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/media\/3700"}],"wp:attachment":[{"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/media?parent=3696"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/categories?post=3696"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/tags?post=3696"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.healthasyst.com\/healthcare-it-services\/wp-json\/wp\/v2\/ppma_author?post=3696"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}