Healthcare Payers

Healthcare Payers

QualiTest has many years of experience in testing the core administrative IT platforms that facilitate the key functions involved with healthcare payers.

Healthcare payers rely on core administrative IT platforms to facilitate most of their key functions. Membership enrollment, eligibility, subscriber inquiries, providers, and claims adjudication are just some of the major functions entrusted to these systems.

There are a number of different vendors providing core administrative IT systems to healthcare payers. QualiTest has many years of experience in testing systems from many of the leading suppliers including  DST Health Solutions, Trizetto, and more.

Mobile Testing Services


Testing Healthcare Payer systems requires in-depth knowledge of the health care insurance claims process, including how the following transactions are handled:

  • Claims 837
  • Referral & Authorization 278
  • Premium Payment
  • Clearinghouses
  • EDI/Paper Claims
  • Remittance 835
  • Claims Status 276/277
  • Capitation
  • Premium Payments 820
  • Eligibility 270/271
  • Enrollment 834
  • Encounters

Reviewing existing test assets (Plans, procedures, data…), coupled with Healthcare Payer IT systems knowledge, the QualiTest team brings its special software testing and QA expertise.

  • Exploratory & Scripted Testing
  • Defect life cycle
  • Test metrics
  • Test Data & Test Data Management (HIPAA Compliance)
  • Requirement Traceability
  • Environments – Prod., Dev., Test, Training
  • Test Cycles
  • Master Test Plan
  • Team Ramp Up
  • System Breakdown
  • Test Automation
  • Performance Testing
  • Security Testing
  • Mobile Device and Website Testing