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Procella Health

Resolving Technical Debt to Ready a Pharmacy Benefits Claims Processing Platform for Market

Review Summary
  • Pharmacy Benefits
  • UX Design, Development
  • Pharmacy Benefit Claims Processing Platform
  • 100K – 20M Users
  • Florida, USA

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.”

Timothy Humphreys – Managing Partner, Procella Health

CASE STUDY
  • Critical Numbers
  • Summary
  • The Problem
  • How we Helped
  • Results/ROI
  • Client Testimonial

 

Procella Health, 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 20M members monthly. 

Despite significant investment with another development partner, the client was still unable to move forward and 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.

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

“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.”

Timothy Humphreys – Managing Partner, Procella Health

Summary

The Problem

Procella Health faced a mountain of technical debt generated by their previous partner and was unable to move the product forward

Development was originally scheduled to be completed by October 2020 but was delayed twice

Had invested close to $4 million with its previous development partner and did not receive a market-ready product

Previous partner wasted time on inefficient requirements, meetings, and indecipherable documentation

A number of key broken features existed within the application, including issues with cross-browser compatibility

Was spending their own time on manual end-to-end QA testing, which repeatedly revealed significant issues


How We Helped

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.

Quality Assurance

Conducting a daily bug triage with the client’s backend team and outsourced QA team to help expedite the feedback loop and provide more visibility about where bugs were coming from

Industry Regulation Compliance

Developed an intuitive claim submission tool which complied with the NCPDP standards, 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 switch 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.


The Outcomes

Accelerated the application’s release timeline from 2022 to 2020

Came in 8% under budget

Removed major code inconsistencies caused by the previous development partner

Initial product demos got positive reviews

“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.”

Timothy Humphreys – Managing Partner, Procella Health

The Problem

The client chose Praxent to succeed where its previous partner had fallen short, 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 quickly.

  • Extended Timelines: Development of the application, which originally was scheduled to be completed by October 2020, was delayed twice.
  • Growing Costs: The client had significant investment 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 lacking 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 several 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 including the User Interface (UI) and API.

Recommending Vue.JS framework, because it would enable the client to gradually implement the new frontend technology page by page. It also blends well within the model view controller architecture the client already had.

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 

“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.”

Timothy Humphreys – Managing Partner, Procella Health

Results/ROI

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—due to previous development partners 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.

“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.”

Timothy Humphreys – Managing Partner, Procella Health

Client Testimonial

Why Praxent

“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.

The group we were using beforehand was based on the West Coast, and it felt more important that their employees get in-office perks during the work day than to ask us questions when they had an issue. It became apparent that a couple of people they brought on to the project, though very nice and well intentioned, did not have the skill set required for the project. Overall, we would have benefited from increased management.

We wanted an enterprise-class platform that could handle our various lines of business.

There are a couple reasons we chose Praxent over other providers. We had looked in the marketplace for key shops, and we looked at their staff. Basically, we were looking for somebody that was known as professional, knew how to conclude jobs, was highly rated. We did various searches. We also engaged on an outside resource to do a little follow up and digging into Praxent, and they came out with very good reviews of the process and the team overall.

Praxent definitely exceeded our expectations. They opened our eyes to a lot of technical debt—we were unaware how prevalent it really was.

There were a number of key individuals that were standouts, but the UI team has done a fabulous job in what they provided and in how they gathered the information. There were definitely some key developers that were always supportive. 

For the duration of the project, there wasn’t a whole lot of turnover as sometimes happens.

They definitely addressed the underlying technical debt and brought us to a place that makes moving forward much easier.

Overall, it has been a very positive relationship, a positive partnership.”

The Handoff

About the transition from the old development shop to Praxent: “Let’s just say the previous development group did everything they could to discourage a transition, not really focusing on anything other than ‘Well in transition, things always get worse.’ They did everything they could to try and scare us off the transition, which, to me, is another issue.

About the transition from Praxent at the end of the engagement: “The handoff was as smooth and as well done as I could have imagined.

“The Praxent team spent a lot of time, for instance, I think it was Nadeem that made sure he recorded significant amounts of information. So it wasn’t just ‘Here’s a document.’ He provided a recording of everything like the status it’s in and so forth. It gave the team on our side invaluable information. The UI team did a great job making sure that all of the screen information they had was as up to date as possible and available in the Invision account for us to take over.

“So, it was very well documented. The project management team kept everything as up to date in terms of the documentation as possible. People made themselves available to ensure that if we had questions or were looking for information, they knew where it was and they provided us the guidance.

“There has been nothing negative. It’s all been positive as it relates to the transition and the code that’s been developed and cleaned up by the Praxent team. It’s all been positive.

“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.

“We’re able to do small things now. Through all of the previous development, all the code was stored in different branches. It took us probably till close to the end of our time frame together that we actually got all of the code into a single branch. That was a major issue the team took care of. A lot of the application itself is very consistent; there was a lot of reuse, and the previous development team didn’t tend to take advantage of that. The Praxent team did a great job of moving those things toward more consistency throughout the entire platform, as well as being able to get some things done quicker than the previous team did because of that reuse.

“I’m much more confident in the platform than I was when the old development team had supposedly gotten it ready for us.

“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.”

Results

“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 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.’

“We had a short-term requirement that Eric was extremely helpful with in terms of getting an API for a pharmacy chain to submit test claims effectively, and we were able to work with him and obviously others on the team, but they were able to get that up and running in the time we had allotted for it, which was a little shorter than many other projects.”

Testimonial provided by Timothy Humphreys – Managing Partner, Procella Health

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