8/2/2019 Amerigroup - API Mangement for Mobile
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AmerigroupCorporationisaFortune500companyandtheninthlargestpublicly
tradedhealthcarecompanyintheUnitedStateswithmorethan1.9millionmembers
in11
states
nationwide.
Founded
in
1994,
Amerigroup
focuses
on
coordinating
local
MedicareandMedicaidprogramsfortheUSgovernment.Infact,oneoutofevery45
MedicaidrecipientsisservicedbyAmerigroupnationwide.Withmorethanfour
thousandemployeesacrosstheU.S.,Amerigroupprocesses24millionclaimsannually
foroperations,prescriptiondrugbenefits,ambulatorycare,andmore.
AstheU.S.federalgovernmentslocalhealthcarerepresentative,Amerigroupaccepts
alleligiblepeople(regardlessofage,sex,raceordisability)anddoesnotdeny
coverageduetopreexistingmedicalconditions.ToaccommodateAmerigroup
memberswhoaredisabled,bedriddenorotherwisecannotgettooneof
Amerigroupsoffices,associatesmakemorethan2millionoutcallsannuallyinorder
toassess
members
health
needs
and
ensure
theyre
getting
the
right
care.
While
Amerigroup
processes
more
than
80percentofinsuranceclaimselectronically,theassociatesonoutcallsrecordmeetingsonpaper,returntothe
officeandkeyinthedata.Aswithmostdataentrywork,thissystemispronetoerrorsthatraisecostsanddelay
processing.Bringingthisaspectofthebusinessonlinewasakeychallengetoprovidingbetter,moretimelycare
formembers.
The Business Challenge
AmerigroupsITgroupheadquarteredinVirginiaBeach,Virginialookedatvariousapproachesthatwouldprovidea
securewayforassociatestomanagememberselectronicallyinrealtimefromanylocation.Asaresult,
AmerigroupdesignedanddevelopedamobileapplicationfortheAppleiPadthatcaninteractivelyassessand
recordthehealthcareneedsofmembersintheirhomesorotherplacesofcare.
Althoughthis
approach
facilitated
mobility,
ultimately
the
iPad
offered
little
more
than
away
to
create
islands
of
informationiftheycouldntconnectbacktoAmerigroupsdatacenterwhereitssystemsofrecordresided.But
transmittingmemberinformationovercosteffectivepublicnetworksraisedanumberofsecurityquestionsfor
Amerigroup.Forexample,thesensitivedatahadtomeetstringentHIPAApatientprivacyrequirementsentailing
encryptionoverthewire,buttherewerealsoquestionsaroundsafelytraversingAmerigroupscorporatefirewall
inordertoaccessitsinternalapplicationsexposedasAPIbasedWebservices.TheITgroupconsideredaVPN
basedapproachbutdidntthinkitstreamlinedenoughtheywantedsomethingthatwouldjustwork.
Enter Layer 7
Inlate2010,AmerigroupputoutanRFPforanAPImanagementprojectdesignedtosecurelyconnectitsinternal
applicationstomobiletablets,andobtainedanumberofresponsesfromvendorsthatpromisedtocoordinatethe
wholeproject
for
them
ifonly
theyd
take
aback
seat
and
just
trust
them.
Amerigroup
selected
Layer
7
TechnologiesnotonlybecauseofLayer7sabilitytoworkcollaborativelywithAmerigroupsITteam,butalso
becauseofLayer7simpressivesecuritycredentials,easeofuse,andflexibilitytomeetthetightdeadlinesofthe
project.Infact,theLayer7Gatewaywasupandrunninginlessthanaweek,providingtheAPIsecurityanddata
routingAmerigrouprequired,effectivelyfirewallingitsJBOSSbasedEnterpriseServiceBus(ESB)whileguardingit
againstintrusionwithstrictAPIauthentication,authorizationandcomprehensivethreatprotection.
Amerigroup by
the Numbers 1.9 million members
$5.2B in revenues (2009)
4,000 employees
49 offices/facilities US-wide
2.2M out-calls to members,
assessing their health needs
24M claims processed yearly
Amerigroup CorporationEnablingMobileMedicaidviaAPIManagement
8/2/2019 Amerigroup - API Mangement for Mobile
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Amerigroup Case Study
Copyright2012Layer7TechnologiesInc.Allrightsreserved.SecureSpanandtheLayer7Technologiesdesignmarkare
trademarksofLayer7TechnologiesInc.Allothertrademarksandcopyrightsarethepropertyoftheirrespectiveowners. 2
The Solution
InproductioninTexassinceFebruary2011,AmerigroupsmobileAPImanagementsolutionservesapproximately
80,000Medicaidrecipientsthroughoutthestate.Initially,fiftycaseworkerswereequippedwiththeAppleiPadin
ordertoproviderealtimeinteractionwithmembersattheirresidencesorplacesoftreatment,butthatnumberis
growing.
Informationis
recorded
interactively
directly
within
the
iPad
application,
and
the
data
synchronized
back
to
AmerigroupsdatacenteroncetheassociatehasaccesstoaWiFior3Gaccesspoint.WhentheiPadapplication
connectsovertheInternettoAmerigroup,theincomingXMLmessagesarescreenedforthreatsbytheLayer7
devicelocatedintheDMZ.TheincominguserisauthenticatedandauthorizedagainstthelocalLDAPbeforebeing
routedviaAmerigroupsESBtoupdatetheappropriatesystemofrecord.Troubleshootingisstreamlinedbyeasy
accesstoLayer7logfilesthatshowrequestsandresponsesastheyhappen,simplifyingdiagnosis,andhelpingto
ensurehighavailability.
The Results
TheiPadapplicationallowsAmerigrouptoimproveitshealthcarecoverageandmemberservices,whileincreasing
theeffectivenessandefficiencyofitsMedicaidprogram.Atthesametime,AmerigroupishelpingTexastomanage
thehealthcareneedsofitscitizens,whilekeepingitmoreaffordablefortaxpayers.
TheAPIbasedsolutionthatconnectstheiPadapptoAmerigroupsinternalsystemsiskeytoadvancingthe
efficiencyandcapabilityofAmerigroupsassociates,allowingthemtoreducetimespentonadministrativetasks
andincreasetimespentwithmembers.Andwithrealtimeinformationgatheredfrommembers,Amerigroups
timetodecisionmakinghasbeengreatlyreduced.
Goingforward,Amerigroupislookingatextendingthesolutiontobusinesspartners,whichincluderadiologists,
testandlabservices,andhospitalsthatwouldthenbeabletosubmitclaimsdirectlytoAmerigroup,further
streamliningandsimplifyingtheclaimsprocess.