claims processing system

8/11/2019 Claims Processing System

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Synopsis: Web Based Claims Processing System (WCPS)

A

PRACTICAL TRAINING REPORT

ON

Web Claim Processing System

SUBMITTED IN PARTIAL FULFILLMENT F T!E RE"UIREMENT FR

CMPLETIN F DE#REE

MASTER F CMPUTER APPLICATIN

B$

Name% Amit &'mar #a'tam

Roll No()**+,)-**.

Co'rse% MCA/0I Sem1

SUBMITTED T

B2S2A CLLE#E F EN#INEERIN# ANDTEC!NL#$

Mat3'ra(45)**-/U2P21

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ACKNOWLEDGEMENT

Keep away from people who try to belittle your ambitions. Small

people always do that, but the really great make you feel that you too,

can become great.

I take this opportunity to express my sincere thanks and deep

gratitude to all those people who extended their wholehearted co-operation

and have helped me in completing this project successfully.

First of all, I would like to thank Mr. Nitin, Director (Z!for

creating opportunities to undertake me in the esteemed organization.

Special thanks to r."an#an !roject anager for all the help and

guidance extended to me "y him in every stage during my training. #is

inspiring suggestions and timely guidance ena"led me to perceive the various

aspects of the project in a new light.

I am highly inde"ted and graceful to $$$$(%ro#ect &eader! and

$$$$ ('eam &eader!for $heir strict supervision, constant encouragement,

inspiration and guidance, which ensure the worthiness of my work. %orking

under them was an enrich experience. I express my sincere thanks to my

senior of software development department for their encouragement and

valua"le suggestion

I would also thank to my Mr.%radeep Maheswari, #&' ()*

'ept.+ my internal project guide Mr. "an#an who guided me a lot in

completing this project.I would also like to thank my parents project mate

for guiding and encouraging me throughout the duration of the project.

In all I found a congenial work environment in and this

completion of the project will mark a new "eginning for me in the coming

days.

Name% Amit &'mar #a'tam MCA (6it3Sem

Roll No2 % )**+,)-**.

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DECLARATION

I, )mit Kumar *autam, here"y declare that the report of the project

entitled + has not presented as a part of any other academic work to

get my degree or certificate except -.S.) /&00*0 /1 0N*2N00"2N* )ND

'03N/&/*4,M)'35") for the fulfillment of the reuirements for the

degree of aster of )omputer *pplication.

Name: Amit KumarGautam

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CERTIFICATE OF ORIGINALITY

$his is to certify that the project entitled $$$$"eing su"mitted for the

partial fulfillment of degree of )*, session /0/-/01, is a record of work

carried out "y Name under my guidance and supervision.

$his is to further certify that the student has attended the Multisoft

Systems, N/2D) for the 6months after the fifth semester theory exams. #is

work has "een satisfactory and commenda"le.

I wish him success in his life.

Date7

%lace7

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CERTIFICATE

$his is to certify that Name, a "onefide student of )* of "atch /0/has

completed the !roject titled +8eb laim %rocessing System "eing

su"mitted for the partial fulfillment of degree of )*.

$his is to further certify that the student has attended the ollege name

. and , N/2D) for the 2 months after the fifth semester theory

exams. #is work has "een satisfactory and commenda"le.

Date7

Mr.

3/D M) Department%lace7

ollege name

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TABLE OF CONTENTS

1. PROBLEM DEFINITION AND SCOPE OF PROJECT 22222222222222222222222222222222222222222222222222222222222222222222222222222225

1"1 P#rpose..................................................................................................................................81"2 $b%ecti&e...............................................................................................................................91"3 Pro%ect Scope.....................................................................................................................101" 'ecnologies......................................................................................................................10

1""1 $perating n&ironment.........................................................................................101""2 *eployment n&ironment.....................................................................................111""3 *e&elopment 'ools and 'ecnologies..............................................................121"" *e&elopment n&ironment..................................................................................15

2. OVERALL DESCRIPTION222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222)+

2"1 +ser Caracteristics.......................................................................................................162"1"1 mployee....................................................................................................................162"1"2 CP* , Claims Processing *epartment..............................................................16

2" 2"-ss#mptions.....................................................................................................................16

. SYSTEM FEAT!RES2222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222)7

3" 1"Systern .eat#res..............................................................................................................173"1"1 "*escription:..............................................................................................................173"1 "2"Constraints................................................................................................................17

". PRELIMINARY DESIGN2222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222)5

"1 +se Case...........................................................................................................................18"2 Specication o. actors...................................................................................................19

"2"1 mployee....................................................................................................................19"2"2 CP* , Claims Processing *epartment..............................................................19

"3 Specication o. +se Cases...........................................................................................20"3"1 +se Case .................................................................................. anage mployee

20

"3"2 +se Case" .............................................................................................. -pply Claim22

"3"3 +se Case" ........................................................................................ -ppro&e Claim

24"3" +se Case" ........................................................................................... System ogin

26" Process lo Cart..........................................................................................................28

".# ENTITY DATA MODEL DIAGRAM 22222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222248

".$ DATA DICTIONARY2222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222247

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"5"1 'able: emp6master.................................................................................................. 27"5"2 'able: emp6claims................................................................................................... 28

#. F!T!RE EN%ANCEMENT222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222248

&. BIBLIOGRAP%Y222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222222 .*

4"1 Websites.............................................................................................................................. 304"2 Boo7s.................................................................................................................................... 30

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1. Pr'()*m D*+,iti', a,- /'0* ' 0r'*/t

1.1 Purpose

-BC is a company ic is a&ing employee strengt o. at least 1000" -ll teemployees are pro&ided medical reimb#rsement .acility ic means tat tee8pendit#re inc#rred by te employee .or treatment is reimb#rsed by tecompany" or reimb#rsement9 te employee needs to ll in a .orm detailing tetreatment #nderta7en ic incl#des te name cost o. medicines9 laboratorytests9 s#rgery" 'e .orm is d#ly signed by te employee and it ill be sent tote concerned Claims Processing *epartment (CP*) by messenger .orprocessing" CP* ill process it and te order regarding te reimb#rsement issent to te Cas co#nter (CC) ere in te employee can come and recei&ete reimb#rsement amo#nt"

Some o. te problems associated it te abo&e mentioned process are listedbelo:

'e .orm may miss d#ring transit

'e .orm is prone to eariness d#e to ic te company may not beable to read data in it a.ter some years"

'e employees o claimed .or medical reimb#rsement need to &isit teCC .rom time to time en;#iring abo#t te stat#s o. teir application" 'isres#lts in enormo#s astage o. time o. te employee"

'o o&ercome tese problems9 it is proposed to de&elop a so.tare titled 3*(Ba*- C)aim Pr'/*i,4 S5t*m 63CPS7ic is eb based so tat teemployee can ll te .orm online and s#bmit it so tat te .orm is sent to CP*tro#g


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1.2 Objective

Web Based Claims Processing System (WCPS) is complete end to end sol#tionto co&er all aspects o. online claim and reimb#rsement system"

'e basic ob%ecti&e o. de&eloping tis pro%ect is:

Pro&ides complete eb site sol#tion9 incl#ding employee registration9enter ne claim9 appro&e/ re%ect claim" Complete eb basedadministration"

'e Web Based Claims Processing System can a#tomatically displaypending claim co#nt in te main page o. employee o. Claims Processing*epartment (CP*)"

mployee can &ie teir claim stat#s online and all claims can be treatedas Pending9 -ppro&ed and >e%ected"

mployee o. CP* can add9 edit employee details9 all employees areidentied by te employee no" mployee no ill be #ni;#e tro#go#tte system"

System m#st store a#dit trail o. all * transaction9 li7e it storesemployee no9 time stamp in te database .or add9 edit9 delete operation"

System so#ld capt#re lat login time .or all te employees"

Complete eb based system no installation re;#ired to r#n teapplication in client system"

mployee m#st able to &ie is/er pre&io#s claim details"

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1.3 Project Scope

'e Web Based Claims Processing System (WCPS) ill permit to enter neclaim9 trac7 te claim stat#s and maintaining master in.ormation" 'e main#sers o. te pro%ect are mployee o. all departments and mployee o. CP* @

Claim Processing *epartment"

rom an end,#ser perspecti&e9 te Web Based Claims Processing SystemPro%ect consists o. to .#nctional elements: enanced mployee mod#les .orogin9 -pply .or ne claim9 &ie stat#s o. already applied claim" -nd CP*mod#le .or appro&e/re%ect claim9 &ie pending stat#s9 -dd/dit employeedetails"

1.4 Technoo!ies

1.".1 O0*rati,4 E,8ir',m*,t

$,1: 'e WCPS eb application ill operate it te .olloingWeb Brosers: icroso.t e;#irements: 2!4(minim#m)/!12(recommended) B

>-

$,=: Eard disc, nFB depending #pon te re;#irement to store dataminim#m o. 2!FB"

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1.".2 D*0)'5m*,t E,8ir',m*,t

*,1: *atabase Ser&er$S @ Win 2003 nterprise Ser&erS Ser&er 200!

E** @ in 10 FB9 >ecommended 2! FB>- @ in 2 FB9 >ecommended FBProcessor , Penti#m *#al Aenon Processor

*,2: -pplication Ser&er$S @ Win 2003 nterprise Ser&er


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1.". D*8*)'0m*,t T'') a,- T*/9,')'4i*

DT1:ASP.N*t-s e need to de&elop Web -pplication .or Web Based Claims

Processing System (WCPS)" We ill #se -SP"Net as it is te ne

icroso.t tecnology to de&elop any application ic s#pport and

integrate oter ser&er prod#ct .or te internet" By -SP"Net e can

de&elop in eb application by "N' .rameor7 and manage

en&ironment it any "N' s#pport lang#age li7e IB"Net and C"

DT2: C;"N' is b#ilt on te Windos Ser&er System to ta7e ma%or

ad&antage o. te $S and ic comes it a ost o. diJerent

ser&ers ic allos .or b#ilding9 deploying9 managing and

maintaining Web,based sol#tions" 'e Windos Ser&er System is

designed it per.ormance as priority and it pro&ides scalability9

reliability9 and manageability .or te global9 Web,enabled

enterprise" 'e Windos Ser&er System integrated so.tare

prod#cts are b#ilt .or interoperability #sing open Web standards

s#c as A and S$-P"

"N' is a KSo.tare Plat.ormK"


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application and reallocation o. memory .or reso#rces tat are not

needed"

'e "N' rameor7 is designed .or cross,lang#age compatibility"

Cross,lang#age compatibility means9 an application ritten in

Iis#al Basic "N' may re.erence a * le ritten in C (C,Sarp)"- Iis#al Basic "N' class migt be deri&ed .rom a C class or &ice

&ersa"

'e "N' rameor7 consists o. to main components:

Common ang#age >#ntime (C>)

Class ibraries

'e ad&antage o. C incl#des

Poer.#l Windos,based -pplications

B#ilding Web,based -pplications

Simplied *eployment

Poer.#l9 le8ible9 Simplied *ata -ccess


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Scalability

>eplication

CentraliMed anagement

>eliability

-#tomating 'as7s

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1."." D*8*)'0m*,t E,8ir',m*,t

DE1: 1.Viua) Stu-i' 2=1= IDEost ad&anced integrated de&elopment en&ironment .or

de&eloping "N' application" icroso.t Iis#al St#dio is anintegrated de&elopment en&ironment (#by among oters as been made

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a&ailable &ia lang#age ser&ices ic are to be installed

separately"


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. S5t*m F*atur*

3. 1.S%stern &e#tures

.1.1 .D*/ri0ti',:

Proposed to de&elop a so.tare titled Web Based Claims Processing System(WCPS) ic is eb based so tat te employee can ll te .orm online ands#bmit it so tat te .orm is sent to CP* tro#g


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". Pr*)imi,ar5 D*i4,

4.1 "se C#se

Web Based Claims Processing System (WCPS) 1"0 ill address te .olloing #se

cases" 'e complete #sage scenarios ill be completed d#ring te in.ormation,

gatering process" +se cases ill be created and prioritiMed" Selected #se

cases ill be e8panded into #sage scenarios and .eat#res tat are deri&ed .rom

bot #se cases and te #sage

scenario

s9 as represented in te .olloing diagram:

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mployee

Syemstogin

anagemployee

-ppro&eClaim

-pply .orClaim

Iie ClaimStat#s

>eports

CP*


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4.3 Speci'c#tion o& "se C#ses

"..1 !* Ca* Ma,a4* Em0)'5**

Ma,a4* Em0)'5**

E)*m*,t D*tai)-ctor CP*

'rigger mployee is not registered in te System and te CP* isto -dd ne employee into te WCPS"

Pre Conditions mployee no is not listed in te system" CP* opens te neemployee page9 and te ne employee page is displayed"

Post Conditions mployee is registered in te system9 ne employee no isgenerated"

Normal co#rse 1" Ne mployee page appears on te screen

2" System increment te last registered mployee No by 1

to get te No .or te ne employee"3" CP* ll in te mployeeOs in.ormation incl#ding Name9

*epartment9 *esignation9 *ate o. Birt9 mail


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!* Ca* Dia4ram : Ma,a4* Em0)'5**

G+se Case: anage mployee @ 'is #se case scenario9 or scenario .or sort9

describes o CP* ill add ne employee into Web Based Claims ProcessingSystem (WCPS)" egistration

Ialidate


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"..2 !* Ca*. A00)5 C)aim

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Ma,4*


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!* Ca* Dia4ram: A00)5 C)aim

G+se Case: -pply Claim @ 'is #se case scenario9 or scenario .or sort9

describes o employee ill apply ne claim into Web Based Claims

Processing System (WCPS)"


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".. !* Ca*. A00r'8* C)aim

A00r'8* C)aim

E)*m*,t D*tai)

-ctor CP*

'rigger CP* staJ ants to appro&e claim

Pre Conditions 'e CP* staJ m#st register into te system9 te CP* islogged into te system9 and te system display pending list.or claim need to appro&e"

Post Conditions Claim stat#s is #pdated and mployee can &ie te stat#s o.is / er claim"

Normal e&ent o 1" CP* logged in"

2" System displays all pending claim details"

3" CP* selects te claim9 &ie te details" CP* #pdated te claim stat#s9 li7e appro&ed / re%ect9

enters remar7s"

!" CP* logged o#t .rom te system"

Iariations N-

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!* Ca* Dia4ram: A00r'8* C)aim

G+se Case: -ppro&e Claim @ 'is #se case scenario9 or scenario .or sort9

describes o CP* staJ appro&ed claim in Web Based Claims Processing

System (WCPS)"


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".." !* Ca*. S5t*m L'4i,

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S5t*m L'4i,

E)*m*,t D*tai)

-ctor mployee9 CP*

'rigger 'e #ser is to start #sing te system"

Pre Conditions 'e #ser is not logged into te system"

Post Conditions 'e #ser is logged into te system9 and te system men# isdisplayed"

Normal co#rse 1" 'e #ser clic7 te lin7 .or teWCPS and a login pageappear on te screen"

2" 'e #ser types is #sername and passord into te .ormand press te login b#tton"

3" 'e system conrms tat te #ser is logged on"

-lternati&e co#rses 2a" 'e #ser is not a &alid #ser or te #ser name or tepassord is

mistyped"

2a1" 'e system re%ect login it an error message tate8press rong

login name or passord"


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4.4 Process Fo( Ch#rt

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Start

ogin

od#le

Selection

CP* mployee

Iie PendingClaim Stat#s

-ppro&e />e%ect Claim

anagemployee

-pply NeClaim

Iie Stat#s

Stop


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".# E,tit5 Data M'-*) Dia4ram 1

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".$ Data Di/ti',ar5

Table: emp_master

Col'mnName Data Ty9e Fiel: Lengt3

Empid int 4

Empname var!ar 50

"epartment var!ar 20

"esi#nati$n var!ar 20

Emailid var!ar 50

"$b var!ar 10

%ddress var!ar 50

&it' var!ar 20

(tate var!ar 20

)$bile var!ar 11

an$ var!ar 20

ban* var!ar 50

pass+$rd var!ar 20

,t'pe var!ar 50

Gemp_mastertable is #sed to store employee details H

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Table% em9;claims

Col'mn Name Data Ty9e Fiel: Lengt3

appid int 4

empid int 4

pname var!ar 50

!$spital var!ar 50

realti$n var!ar 50

appt'pe var!ar 50

disripti$n var!ar 50

laimam$,nt int 4

date var!ar 20

stat,s var!ar 50

apam$,nt int 4

apdate var!ar 20

apdisripti$n var!ar 50

apseen bit 1

Gemp_claimstable is #sed to store claim detailsH

#. Futur* E,9a,/*m*,t

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'is pro%ect as de&eloped to .#lll #ser re;#irementQ oe&er tere are lots o.

scope to impro&e te per.ormance o. te Web Based Claims Processing System

(WCPS) in te area o. #ser inter.ace9 database per.ormance9 and ;#ery

processing time" tc"

So tere are many tings .or .#t#re enancement o. tis pro%ect" 'e .#t#re

enancements tat are possible in te pro%ect are as .ollos"

in7ing and integration o. oter online eb sites"


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&. Bi()i'4ra095

).1 *ebsites

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ttp://"microso.t"com

ttp://"programmer2programmer"net

ttp://"codepro%ect"com

ttp://"asp"net

ttp://"asp123"com

ttp://"i7ipedia"org

).2 Boo+s

olloing boo7s and eboo7 are #sed to complete tis pro%ect reports"

astering C (Paperbac7)

S Ser&er Bible (Paperbac7)

"N' Blac7 Boo7 (Paperbac7)

Pro.essional C9 2nd dition (Paperbac7)

Pro.essional -SP"N' (Paperbac7)

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