Challenge

Republic Indemnity Company of America has been meeting the workers’ compensation needs of small and mid-sized businesses in California and the western United States for nearly half a century. Customers have come to rely on Republic Indemnity’s knowledgeable professionals, who combine responsive service with innovation in developing customized programs.

Republic Indemnity’s goal is to consistently provide customers with quick and reliable service. Doing so requires the company to quickly process claims by working with policy holders as well as with doctors’ offices and state agencies.

To accomplish this, Republic Indemnity sought to streamline processes as much as possible. The company had been exchanging information with business partners by creating RPG programs on its AS400 systems. Though its IT department was able to create a lightweight in-house EDI solution, Republic Indemnity reevaluated this strategy when California changed its regulations requiring insurers to submit claims in the 837 claims format initiated by the Health Insurance Portability and Accountability Act (HIPAA).

“The new California regulation required all companies submitting disability claims to submit them in the same format as the rest of the healthcare industry,” said Dave Alton Assistant Vice President for Republic Indemnity. “Other states were also beginning to have similar requirements, though each state required a slightly different form. To help us meet the California requirement and help avoid similar compatibility issues in the future, we began looking for an integration solution.” 

Approach

Republic Indemnity asked several integration software companies to come in and demonstrate their technology. Boomi sent an integration consultant who set up a full-blown integration and completed the Republic Indemnity proof of concept in a single afternoon. 

“The Boomi Integration Platform met all RFP requirements plus it could do countless other things outside of the scope of what we were looking for at the time,” continued Alton. “And despite having more functionality and being easy to use and set up, it was still less expensive than the competition. It was an easy decision.”

Though Republic Indemnity was primarily looking for business-to-business (B2B) connectivity, Boomi’s built-in application integration capabilities make it easy for Republic Indemnity to connect its own applications to each other while also conducting business with business partners over the internet.

“The Boomi Integration Platform could meet our B2B and application integration needs with a single offering. Boomi’s product is a true end-to-end solution,” commented Alton.

Results

After four days of training, Republic Indemnity set up its integration environment in less than a week. According to Anupama Ponto, EDI manager for Republic Indemnity, “Being able to set up a product and an integration process of this complexity in such a short timeframe says a lot about the product.”

Today Republic Indemnity has numerous mission critical processes in production with plans to roll out several more. These processes connect approximately 15 internal applications and also allow the company to connect directly to outside organizations.

As an example, Republic Indemnity integrates claims data directly with state systems in compliance with each state’s varying regulations. Historically, the company would have had developers create this over the span of months. Now it is able to capitalize on the integration processes developed for one state by deploying the same process to additional states with only minor revisions based on differences in policy from one state to the next.

“When we need to set up a new state process, 90% of the process is already done. The amount of time needed for mapping the data is greatly reduced, which means we can set up the process in two weeks – a dramatic time savings versus the months it used to take. This repeatability is critical for us,” commented Ponto. 

Boomi’s Integration Platform plays a central role in processing Republic Indeminity’s workers compensation claims. Initially, a claim report is input into the document imaging system which indexes the claim. Republic Indemnity then reports it to the state through AS400. Boomi takes the AS400 file, formats it to comply with 837, and sends it to California. The state responds with a 997 (an acknowledgement they’ve received it) and an 824 (this accepts or rejects the claim based on transactional integrity). The claims are submitted through secure FTP.

“Processes that once took two to three months now take two to three weeks,” commented Ponto. “Though I have technical skills, I’m not a programmer. Without a need for coding, I can set up integrations easily as well as handle all upgrades and maintain the system. If ever I have any questions, the Boomi team gets back to me quickly with the information I need.”

Dave Alton summarized the experience by saying, “Boomi has continually demonstrated its commitment to Republic Indemnity. We’ve saved money in programming costs while improving our efficiency. This was accomplished quickly, at a reasonable price and without a team of consultants or developers.”

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