Regulatory scope
PIPEDA · Canada Revenue Agency · Alberta Revenue Agency · province-specific regulatory policies · HIPAA-aligned controls
Multi-Payer Claims Adjudication, Rebuilt from Desktop Monolith to Microservices
Quikcard, Canada's leading health benefits provider, ran its entire claim lifecycle - initiation, adjudication, settlement, payment and reporting - on a desktop application bound to an Oracle database. Seasia rebuilt it as a cloud-ready microservices platform handling multi-payer operations across Wellness, Health, Vision and Drug programs, with a configurable rules engine, automated payments and AI-assisted claim triage.
Overview
INDUSTRY
Health Insurance / Healthcare Payer
Geography
7 years, ongoing
The Health Management System is an enterprise healthcare management and insurance automation platform that digitizes the complete claims and revenue cycle lifecycle. It enables multi-payer operations with payer-specific rules, credentialing, eligibility validation and settlement logic, supporting both employer-sponsored and government-backed benefit plans including low-income and adult claims.
The platform delivers end-to-end claims processing from initiation and adjudication through settlement and payment across Wellness, Health, Vision and Drug programs, and provides real-time visibility into claims status, funding, payer responses and settlement outcomes.
Overview
The Health Management System is an enterprise healthcare management and insurance automation platform that digitizes the complete claims and revenue cycle lifecycle. It enables multi-payer operations with payer-specific rules, credentialing, eligibility validation and settlement logic, supporting both employer-sponsored and government-backed benefit plans including low-income and adult claims.
The platform delivers end-to-end claims processing from initiation and adjudication through settlement and payment across Wellness, Health, Vision and Drug programs, and provides real-time visibility into claims status, funding, payer responses and settlement outcomes.
INDUSTRY
Health Insurance / Healthcare Payer
Geography
7 years, ongoing
Project Scope & Business Challenges
The client needed to modernize a tightly coupled claims platform that handled the full lifecycle from initiation through settlement and payment.
Key challenges included:
A Desktop Monolith Carrying The Entire Claim Lifecycle.
- A thick client bound to Oracle handled initiation, cardholder administration, adjudication, settlement and payment. Every change touched everything; scaling meant scaling the whole application.
Multi-Payer Benefit Logic With No Service Boundaries.
- The platform administers Wellness, Health, Vision and Drug programs across multiple payers, each with its own fee guides, pricing caps and provincial rules. That logic sat inside the monolith, making new payer and plan launches slow and regression prone.
Modernization Without Interrupting Settlement.
- Claims settlement runs continuously, and money moves through it. The migration could not create a processing gap, and financial records had to reconcile exactly across old and new systems throughout.
Solution Offered by Seasia
Seasia engineered a clinically structured CBT platform with controlled progression, guided exercises, outcome tracking, and persistent crisis support pathways. The solution translated therapeutic and regulatory requirements into predictable, auditable product workflows.
Structured program engine
The CBT course is modelled as sessions, parts and pages, driven by a controlled page array, so progression is sequential, predictable, and clinically faithful. The progress bar updates proportionally as each page completes.
Sequential session unlocking
Sessions gate on completion of prerequisites, with clear visual state for completed, active and locked, so foundational concepts land before more complex material.
Clinical screening and outcome tracking
A screening instrument at onboarding with a scored results screen, which can be retaken through the program, so users see symptom change over time rather than being told about it.
CBT exercise suite
Worry diary, worry tree, worry script, belief testing and uncertainty management, each a guided structured interaction with instructional video support rather than a free-text box.
Crisis escalation pathway
When screening or reported state falls in the severe range, a crisis support pathway surfaces immediate access to professional crisis services. Safety-critical context persists across interruption and relaunch, so the pathway remains available after the app closes.
AI support companion
An AI conversational companion offering empathetic support between structured sessions in a calm, clearly delineated chat interface, positioned as support alongside the therapeutic program rather than a substitute for it.
Mood tracking and therapy log
Visual mood history with daily entry, and a therapy log letting users read back their own reflections from previous sessions, a clinical feature of CBT, not a journaling add-on.
Multi-layer persistence
Session persistence with secure access and refresh token management under strict expiry rules, data persistence for mood logs, milestones, chat history and self-care records synced across devices; onboarding persistence capturing every answer, branch and skip in real time so a user returns exactly where they left off.
Self-care library and signposting
Mindfulness audio, podcasts and articles, plus signposting to support groups and helplines outside the app.
Reminder and goal engine
Configurable weekly reminders by day, daily goal tracking and personal goal management, supporting the adherence a therapeutic program depends on.
Organization-code onboarding
An optional organization code at signup, enabling employer, insurer and health-system distribution against a single consumer build.
Dynamic admin platform
Screens, content, users and system settings managed from an admin panel, so clinical content updates ship without an app release.
Security and resilience testing
Vulnerability assessment and penetration testing, load and performance testing across mobile, web and backend; high-risk vulnerabilities identified and resolved; API and network hardening; database audits and custom session testing.
WCAG 2.1 AA accessibility
Built to WCAG 2.1 AA throughout, as a design standard rather than a remediation pass.
Our Tech Stack
The platform was structured using a scalable, secure, and integration-ready technology stack suitable for fintech, retail, and payment workflows.
Backend
Java
SpringSpring Boot
REST APIsJPA
MavenArchitecture
MicroservicesAPI Gateway
service discovery
JWT securityFrontend
Angular web portalmobile extensions
Database
Oracle 19cmigrated from Oracle 10plus SQL
Backend
JavaSpringSpring BootREST APIsJPA
MavenArchitecture
MicroservicesAPI Gateway
service discovery
JWT securityFrontend
Angular web portalmobile extensions
Database
Oracle 19cmigrated from Oracle 10plus SQL
Compliance & Security
The platform was structured with a scalable, secure, and integration-ready technology stack suitable for fintech, retail, and payment workflows.
Safeguards
JWT authentication, credential-based access control for payer workflows, secure payer data segregation, audit-ready logging of payer actions and decisions, encryption of data
Data handling
Secure data handling with enterprise-grade controls; role-based access, audit logging and data traceability for regulatory reporting
Delivery standards
ISO 27001
CMMI Level 5
Features & Outcomes Delivered
The platform combined structured CBT delivery, patient self-management, safety workflows, content administration, and enterprise-grade controls in a single regulated digital health experience. The result was a clinically guided system designed for continuity, accessibility, and scalable organizational deployment.
Clinical Programs & Therapeutic Workflows
- Structured CBT program with sequential session unlocking
- Clinical screening with scored results and retake tracking
- Worry diary, worry tree, worry script, belief testing and uncertainty management exercises
- Therapy log with cross-session reflection recall
- Goal setting and daily goal management
Patient Support & Engagement
- AI conversational support companion
- Mood tracking with visual history
- Configurable weekly reminders
- Self-care library with mindfulness audio, podcasts, articles and external signposting
Safety & Continuity Of Care
- Crisis escalation pathway with persistent safety–critical state
- Multi-layer persistence across session, data and onboarding state
Administration & Enterprise Distribution
- Organization-code onboarding for employer and health-system distribution
- Dynamic content and user administration platform
Accessibility, Security & Quality Assurance
- WCAG 2.1 AA accessibility throughout
- VAPT, load and performance test program
Results
A Class I medical device, UKCA-marked for Great Britain
A structured CBT program in production on iOS and Android
WCAG 2.1 AA conformance built in from design rather than retrofitted
VAPT, load and performance testing completed with high-risk vulnerabilities resolved
Role-based access control and strict session management implemented across the platform
Clinical content updates shipping through the admin panel without an app release
Ongoing maintenance keeping the platform secure and performance-optimized
A 3-year engagement, still running
Modernizing a Claims platform?
Seasia helps insurers and healthcare organizations modernize legacy claims systems with modular architecture, configurable rules, automated adjudication, and integrated financial workflows.
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