Resolving Technical Debt to Ready a Pharmacy Benefits Claims Processing Platform for Market
Delivery of Clean, Consistent, Well-Documented Code Ensures Future Success
“We’re able to do things for our investors’ plan in a matter of a few minutes that takes other processors 10 days, 30 days to do and release.
We’re able to capture a lot of information, so when people ask, ‘Can you do this?’ we can very simply say, ‘Yes, this is how you do it.”
– Managing Partner
A pharmacy benefits management (PBM) platform was looking to accelerate development of its SaaS product that would enable pharmacy benefits managers and insurance company reps to configure highly customized policies and process claims for 100,000 to 2M users monthly.
Despite having invested roughly $4M with another development partner, the client was still unable to take its claims processing application to market 2 years later and felt extremely frustrated and depleted. They were seeking a new development partner that was highly rated; professional; and most importantly, had the skills to untangle their technical debt and clean up their code, increase functionality, clean up the user interface, improve the user experience, and provide them with a roadmap for launching their product in the $25 billion pharmacy benefits technology space.
“We were looking for a development team that was more professional than the one we were using beforehand, a group that could ramp up much quicker than our previous vendor could, and a group that actually would listen, more than simply think they knew what they were doing. Praxent definitely exceeded our expectations. Everything the Praxent team touched made an impact. I’m much more confident in the platform now.”
– Managing Partner
50+ workflows designed and developed
14 months from concept to product
2 years earlier release Praxent accelerated app’s release timeline from 2022 to 2020
8% under budget
The Problem
The client chose Praxent to succeed where its previous partner had failed, to deliver a development-ready application on time and on budget with clean, consistent, well-documented code and outstanding UX/UI. Their biggest challenge was to overcome the mountain of technical debt generated by their previous partner, which had left them unable to move forward.
- Extended Timelines: Development of the application, which originally was scheduled to be completed by October 2020, was delayed twice.
- Growing Costs: The client had invested close to $4 million with its previous development partner and did not receive a market-ready product.
- Massive Inefficiencies: The client’s previous partner wasted time on inefficient requirements, meetings, and indecipherable documentation.
- Integration Gaps: Because the application layers were tested in silos, they were not fully integrated. The UI screens matched the wireframes, but they were not connected to the database or API.
- Non-Existent QA: The client was having to spend as many as five hours of their own time on manual end-to-end QA testing, which repeatedly revealed significant issues.
- Outstanding Bugs: There were a number of broken features within the application, including issues with cross-browser compatibility. This was a major problem because most users were deploying the application on Windows-based operating systems.
How we Helped
Praxent’s mission was to provide a cleaner, more intuitive UI/UX for the client’s claims processing application that would enable users to quickly and easily edit records and validate claims details. Not only did Praxent address the client’s underlying technical debt but the development team made significant edits that allowed for a more consistent, user-friendly workflow; delivered clean, well-documented code; and made clear recommendations for future deployment of features and a go-to-market strategy.
The approach included:
Design
- Auditing screen designs with UX recommendations for workflow improvements
- Creating development ready, high-fidelity screen designs
- Ongoing review of developed features to ensure compliance with design guidelines
Development & QA
- Developing a revenue-generating product using Java, React, MySQL, AWS, and Jenkins.
- Developing a complete the front-end website development including the User Interface (UI) and API.
- Finalizing open technical architecture decisions (left over from previous development partner)
- Refining sitemap
- Performing end-to-end testing with each sprint to ensure high-quality code delivery
Project Management
- Creating a product backlog and plan for next major release with epics, user stories, and estimates
- Presenting a go-to-market plan, including timeline, budget, and scope
- Weekly status reporting of budget, scope, and timeline progress
Handoff/Knowledge Transfer
- Aligning with client stakeholders on a detailed “Ramp Down” project checklist and hand-off for their product
- Created clear, concise, up to date code documentation and recorded demos throughout the engagement
- Packaged up all code, documentation, design files and guides at the end of the engagement
- Ensured team members were available afterward to provide ongoing guidance and support
Result
The Praxent team’s work accelerated the application’s release timeline from 2022 to 2020 and came in 8% under budget with positive reviews of the initial product demos.
Praxent removed major inconsistencies throughout the entire platform—caused by the previous development partner’s having stored all of the code in separate branches—and created a single branch of code, taking advantage of reuse wherever possible. The result was a platform that was consistent throughout, and the team’s reuse of code saved the client time and money.
Thanks to a smooth handoff, clear recommendations, and ongoing support from the Praxent team, the client’s team was able to move forward with the application with no issues.
“Everything the Praxent team touched made an impact. For instance, there are edits that control how a claim processes. While the previous team created a number of these, it wasn’t always done as well as it should be. It wasn’t consistent from one type to the next. The Praxent folks understood that continuity, that consistency, and a lot of their clean up changed it to move it in a consistent direction. It sounds very simple, but it was an extremely important part of how the platform needs to function. So they definitely took us from a lot of not necessarily consistent approaches to a much more consistent approach, a much more user-friendly workflow.
“I’m much more confident in the platform than I was when the old development team had supposedly gotten it ready for us.
“Somebody had seen the product demo and said, ‘You’re basically building a Ferrari rather than a Chevy, and in this industry that actually makes a lot of sense in terms of understanding that distinction.’ We’re able to do things for our investors’ plan in a matter of minutes that the other processors need 10 days, 30 days to do and release.”
Key Features/Deliverables
Complex enrollment workflow: Praxent designed an entirely new, user-friendly workflow for a highly-configurable enrollment wizard which simplified an extremely laborious and complicated enrollment process.
A clean, intuitive UX was created so that a pharmacy benefits manager (PBM) can quickly and easily customize and configure a plan for their client by creating a complex set of rules, such as for high and low deductible plans, adding specific thresholds for plan deductibles, copay/coinsurance and enable coordination of benefits.
Industry Regulation Compliance: Developed an intuitive claim submission tool which complied with the NCPDP regulations, a national telecom standard required for processing pharmacy claims. This allows the Pharmacy Benefits Manager to submit claims for internal testing and also send claims to the switchboard for manual reimbursement when required.
Handoff/knowledge transfer: In addition to exporting all code and design files, Praxent provided the client with all technical documentation and meeting notes as well as recorded status updates on every aspect of the project. The UI team ensured all screen information was as up to date as possible before providing the client with access. In addition to a meeting walking the client through specific parts of the handover pack e.g. Jira, key members of the team made themselves available after the project ended to ensure that if the client had questions or was looking for information, they were able to provide immediate answers and guidance.
“I wouldn’t change anything except for, you know, having the whole team sit in our office every day for a couple of months to work through things. They did a great job on the transition.”
