Healthcare IT

    Health Insurance Exchange

    As a systems Integrator of state Health Insurance Exchanges, Dawn offers in-depth knowledge into the complexities of integrating legacy state healthcare systems into modern healthcare reform systems. Our top talent has built solution suites with modularity, sustainability, and reusability in mind. Our State HIX Experience Enables Reusable, Sustainable Solution.

    Dawn’s is a part of systems Integrator of state Health Insurance Exchanges, currently working with an early innovator state while also being a key performer in implementing a state Health Insurance Exchange. No one understands the challenges of implementing a state exchange better than us.

    Implementing an exchange means more than understanding the key components of an exchange, i.e., Eligibility, Plan Presentment, Enrollment, Billing, Case Management, and QHP Certification on a Service Oriented Architecture (SOA) platform. Because SOA permeates Dawn in terms of Software Development Life Cycle (SDLC), architecture approach, technical resources, and thought leadership, we implement exchanges with reusability in mind.

    Why is reusability important? Implementing an exchange with a focus on reusability allows you to create a sustainable environment for your state and leverage components of the exchange for other systems. We create a seamlessly integrated suite of business processes and functionality across the enterprise, not a collection of individual point software products interfaced as part of project implementation. Our platform-based connectivity strategy provides the ability to scale, eliminates costs, and provides an efficient means for interfaces and integration.

    The modular approach complies with Centers for Medicare and Medicaid Services’ (CMS) Seven Conditions and Standards, MITA 3.0, SOA best practices, and applicable Federal and industry standards such as HIPAA, NIEM, NIST, and Section 508. Our SOA architecture is scalable, simplifying upgrades, enhancements, and changes that the exchange may desire as the program matures. With our standards-based open architecture, you can connect and transform any application and technology you choose to deploy.

    Healthcare Going Mobile

    Mobile technology is quickly emerging as a valuable digital channel to provide our members more personalized and real-time service. Dawn has already conducted in-depth consumer research and continues to conduct various pilots regarding the use of mobile applications. Our research shows that consumers are looking for mobile functionality to get convenient access to information that will help them improve their health. Our Client made a decision to develop their our own mobile application, can launch their enterprise mobile Infrastructure and deliver both browser-based mobile applications for various mobile devices as well as downloadable apps for iPhone and Droid smart phones and an optimized website for tablet visitors.

    Dawn launched their first enterprise mobile solution - the mobile-optimized find a Doctor web experience. Since launch, we have experienced over 365,000 transactions on the new mobile Find a Doctor tool.

    Dawn is committed in expanding our client’s mobile experience for their consumers and members on an ongoing basis with enhanced capabilities.

    The completed charter addresses the specific need to:

    • 1. View the Claims Overview and Claims details of the member and their dependents
    • 2. View Plans and Benefit information
    • 3. Estimate Costs of Procedures in different states and countries
    • 4. Create downloadable apps for Android and IPhone for the above 3 cases along with Mobile web

    The below is an extract from the Enterprise Mobile Strategy document presented to our client leadership .Based on our research, customer expectations in the mobile healthcare space have not yet crystallized, leaving a narrow window of opportunity for our Client to develop a valuable consumer offering. The competition cautiously introduced mobile, with no one carrier taking strong leadership or deviating from the pack. Our client competitors currently provide a suite of undifferentiated tools to their members that have not lived up to consumer expectations. However, competitors are defining this category and are establishing early positions by aggressively marketing their capabilities. Information is typically delivered through a secure, password protected mobile web browser for members only. Competitors are leveraging similar vendor solutions to deliver a mobile browser experience to gain speed-to-market. Go beyond singular tools by building integrated experiences that drive "The needs" (e.g., Ticket) of our consumers.

    Overall goals:

    • Integrate with our Customer's lives
    • Provide a connected end-to-end brand experience
    • Delight our members


    Strategic goals:

    • Accelerate core capabilities
    • Build for specific user scenarios
    • Innovate and Differentiate
    • Leverage low-cost, high value channels


    Tactical Goals:

    • Prioritize and build Tier 1/Tier 2 capabilities
    • View Claims Overview & Details
    • View Benefits Summary & Details
    • Estimate Costs of Procedures
    • Align Mobile and Web Experience
    • Continue User Research to refine offerings
    • Members use existing consumer portal registration process to register to access to protected resources.

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