Case Studies of Insurance Integration Success

Partnering with PilotFish allows leading solutions providers across the insurance industry to leverage modern integration strategies and solutions for a competitive advantage. PilotFish Integration Solutions have met every insurance integration challenge – legacy systems, data silos, standards, new technologies, big data, constrained resources, connectivity issues and more. Our case studies detail how we have helped organizations solve their integration challenges, implement systems faster and improve revenues.

You’ll see how the flexibility that we have architected into our integration engine solutions allows us to adapt to any environment and requirement as well as to changing insurance markets. It has also enabled us to leverage new technologies to provide opportunities for greater operational efficiencies, gains in productivity and better system performance.

PilotFish is the only integration solution that supports all insurance lines of business: Life, Annuities, Health, Reinsurance and Property & Casualty. No other integration product suite offers direct and comprehensive built-in support for ACORD as well. Whether Cloud, Software as a Service (SaaS), on-premises or hybrid – PilotFish has served the insurance industry for 23 years by providing leading solutions to meet insurance’s changing integration needs.

Note: For healthcare integration case studies, visit PilotFish’s Healthcare Focused Website.

Faster Claims Processing

PilotFish dramatically improved a client’s healthcare claims processing and payment remittances system by implementing their Integration Engine Solution suite. This system, which handles X12 EDI 835 and 837 transactions, boosted data handling, parsing, validation, and usability. As a result, processing times were cut from 14 hours to just 45 minutes—an improvement of over 1000%. This transformation not only increased operational efficiency but also created new revenue opportunities and expansion possibilities. EDI 835, EDI 837, Claims Processing, Payment Remittances >

Easy Migration from Sunsetted EDI Claims System

Deep expertise in EDI claims processing averted a crisis for this HMO and delivered fast, easy migration from a sunsetted EDI system. New compliance capacity arrived with PilotFish’s unique EDI SNIP Validation Processor. In this case study, discover how partnering with PilotFish modernized the payer’s EDI claims processing system and compliance infrastructure. EDI 837, EDI 835, SNIP Types 1-7, Compliance, Claims Management >

EDI P&C Claims System

Robust, modern EDI Integration Solution replaced current sunsetted EDI integration system end-to-end. The company gained advanced SNIP validation of types 1-7 with superior accuracy, efficiency, and scalability. Faster cost-effective closure of claims improved profit margins. See how top EDI technology and EDI expertise delivered EDI P&C Claims System >

X12 EDI Specialty Health Insurance Integration

A leading organization that provides health services was experiencing rapid growth and planning to double its size over the next five years. Enhancing its data integration solution was critical to growth projections, improved efficiencies, and reduction of potential risks to its high-volume information processing capabilities. PilotFish provided the client with a cost-effective product replacement path and enhancement of its current solution.

The PilotFish Assembly Line approach ensured that going forward each interface was configured in the same way and updated easily. Leveraging PilotFish’s integration solution with its specialized X12 EDI features ensured robust data integration and accurate validation critical to achieving its goals.  Benefit Management Solution: EDI 271, 837, 834 Integration and more >

AI & ML Underwriting Breakthrough

Automation and AI are mission-critical in today’s P&C marketplace. Carriers must become even faster, more agile and more innovative. This P&C leader implemented a highly collaborative partnership with PilotFish to develop models using Artificial Intelligence (AI) including Natural Language Processing (NLP), and Machine Learning (ML), to achieve improvements in underwriting and quoted rates. By investing in new technology and leveraging PilotFish’s integration solution suite and professional services, this carrier put three AI models into production in less than a year. Learn more about the 3 AI & ML models >

P&C Collaborative Partnership

While every client engagement is unique, PilotFish has replicated trusted partnerships that created great value and delivered remarkable results for clients,  anchored in the sophistication and power of our software and the talent of our professional services. This P&C insurer brought in the right mix of software solutions to tackle faster quoting and underwriting. Real progress was achieved when the right vendor software engineering talent arrived with PilotFish. Visionary IT leadership developed a highly collaborative partnership with PilotFish once the power of PilotFish’s integration technology was put in play. New capabilities unleashed by collaboration became the jumping off point to take advantage of innovations and quickly integrate them in core systems and business processes profitably. Learn how to leverage collaboration for exceptional business results >

Guaranteed Life Modernization 

Struggling to generate value from multi-phased technology modernization efforts? Recent McKinsey research reports that achieving productivity gains at scale is a continuing challenge for the insurance industry. Discover how this large insurer achieved remarkable gains system wide with its technology modernization strategy. Partnering with PilotFIsh powered speed, scalability and greater profitability in project after project. In this improvement project, PilotFish delivered impressive measurable value in automating and transforming the Guaranteed Issue Whole Life business. Guaranteed Life Modernization >

EDI 834 and 837 Claims Integration 

This full-service third-party benefits administrator is a leader in the self-funded employer benefit health and wellness plan space. The company provides employers with strategic benefits plan design, cost-effective benefits administration as well as reporting and analytic services. With PilotFish as a partner, they have been able to capitalize on plan, utilization and claims data to help their customers balance and control the costs of providing benefits. In this case study, discover how PilotFish’s Integration Engine solution and deep expertise in EDI healthcare data exchange helped them modernize their IT capabilities and reduce costs. EDI 834 and 837 Claims Integration >

Automated Insurance Underwriting 

Today the insurance industry is challenged to adapt consumer interfaces and internal processes to rapidly changing purchasing preferences. Automated underwriting solutions are essential to real-time online decision making. Learn how this insurer leveraged PilotFish’s Integration Engine to rapidly integrate its web-based real-time reflexive decision-making engine and downstream legacy systems. Aggressive deadlines were met and stretch goals exceeded. See PilotFish in Action as the Backend Workflow Director and Legacy System Integrator >

Enterprise Integration for Insurance

Learn how one of the world’s largest insurance companies implemented PilotFish as its enterprise solution to meet massive integration requirements. PilotFish’s Integration Engine Solution enabled the rapid integration of scores of industry-specific data feeds. Automation and standardization of the client’s integration process was achieved across a sprawling IT infrastructure. With PilotFish, the client also realized greater advantage from the benefits of implementing the ACORD standard. Implementation times and costs were reduced across its ever-growing product and service offerings. Fortune 100 Insurer Achieves Enterprise Integration on Vast Scale >

ACORD Policy Data Transformation

In this case study, you’ll learn how a Canadian insurance group leveraged the PilotFish Integration Engine solution to read in and parse data for electronic distribution to over 30 agencies and MGAs. In doing so, PilotFish was able to demonstrate the performance and scalability of an eiPlatform interface and deliver an affordable solution on a technology stack with plenty of room for future growth. Massive Insurance Policy Data Transformation Scaled Up and Accelerated >

Agency Integration and Product Bundling

Learn how this leading software provider achieved faster implementations with fewer resources at less cost with the PilotFish Integration Engine Solution. Growing external client demand now was successfully met with the performance and scalability of PilotFish’s eiPlatform. Increasingly inefficient home-grown integration solutions were replaced after partnering with PilotFish. Within six months of inaugurating the new integration platform, significant new business was closed – made possible by bundling and white labeling PilotFish’s modern architecture. Software Provider White-Labels Integration Platform to Reduce Costs and Grow >

Lab ACORD & HL7 Integration

One of North America’s largest labs was on the verge of being buried under a mountain of requests for integration from insurance providers, hospitals, other labs and government entities. In this case study, learn how they partnered with PilotFish to reduce their backlog with a unified approach to data transformation and transmissions to reach the peak of integration capability. Major Lab Leverages Superior Single Integration Solution for Every Implementation >

Laboratory Integration

Real-time data integration and ensuring data integrity was critical to the success of a newly-acquired division of a global clinical testing laboratory that performs hundreds of thousands of tests every day as well as deals with huge volumes of data from many disparate systems. Extremely tight timelines and new systems being developed in concert with the implementation of PilotFish plus a lack of ACORD expertise and IT infrastructure from the acquired firm posed a unique set of challenges. The client relied on PilotFish as their preferred partner because of their expertise and the underlying technology, along with their outsourced services team to implement the solution. Global Clinical Testing Lab Partners for Integration Architecture and ACORD Expertise >

TPA Automates Claims Processing

Employers are increasingly turning to Third Party Administrators (TPAs) to rein in rising healthcare costs and help improve employee health. Processing medical insurance and prescription claims, determining eligibility, managing plans, expenses and wellness programs have traditionally been very resource intensive processes. Transformational change was made possible by leveraging PilotFish’s integration engine solution. Automating these processes and making strategic use of data and analytics allowed this leading TPA to improve customer service, deliver value and design sustainable benefit plans to its booming employer client base. TPA Integrates EDI 834 Fast, Ensures Data Quality, and Cut Costs >

HL7 is the registered trademark of Health Level Seven International.
X12, chartered by the American National Standards Institute for more than 35 years, develops and maintains EDI standards and XML schemas.