The requirements were developed specifically for BOMaid’s Claims and Membership System, therefore, access to key views from the database will be provided. The services will be hosted by BOMaid on their servers.
The web services will facilitate the management and presentations of a number of public facing interfaces which will include, among others:
- GetMemberDetails : Changes need to be made to this web service to include additional information such as exclusions and benefits relevant to provider. This will require reading from the Provider Database to check Provider Type, etc.
- GetProviderClaims : Changes will be required to also include status for each claim (where in the processing chain each claim is). This status is a number and we will want to map every value to an actual worded description for usability purposes.
- GetRemittance : This is a new web service which will collect the remittance for each provider. In its final usage on the portal, the user will be able to download this remittance as an excel file, pdf or just view it.