Customer story · Health insurance

Test automation for the switch to a new national medical tariff

A framework that generates and checks standard-conformant e-bills, so a highly automated invoice process stays reliable through the change to TARDOC.

Talk to us about your project All customer stories

Challenge

The starting point

The insurer processes electronic invoices from doctors and hospitals almost entirely automatically. Switzerland is replacing its outpatient medical tariff, TARMED, with TARDOC, and every change to a tariff has to be tested thoroughly before it reaches that automated flow.

TARDOC has around 2,630 tariff positions and a complex set of rules: the patient's age and gender, the physician's qualifications, which positions may be combined, and more.
Every incoming e-bill has to follow the XML format defined by the Swiss healthcare industry to the letter.
The business units ran their tests by hand and kept their test cases in Excel, which made it hard to trace them against the project milestones.

Approach

What we did

Tools

Java
Jackson
TestNG
REST Assured
Allure
Xray
Oracle

Worked out with the business which parts of the tariff matter most, and derived the parameters that define the possible combinations of test data.
Built a framework that combines existing data from the insurer's database with input parameters into valid XML e-bills, and places them where the claims software picks them up.
A separate part of the framework checks the outcome independently and reports on it.
Connected the framework to the Xray test management tool through its API, so every automated run is recorded against the right test case.

Results

What changed

A Java framework that generates standard-conformant e-bills from 30 to 40 input attributes, covering a wide range of scenarios. The insurer's own teams now maintain and extend it.
An Xray project set up with everything the tests need, about 100 test cases moved over from Excel, and guidance for the testers on writing and maintaining them.
Reports that show in plain language which e-bills were generated and how they were validated.

The services behind this project

Test AutomationUse automated tests to run repeatedly and consistently Test Data ManagementInvolves creating and managing data sets that are used during software testing.Test ManagementEncompass activities required to manage and control the testing process.

Facing something similar?

Tell us about your team and what you're working on. One of our engineers will get back to you.