System and method for automated coding and testing of benefits

A computer-implemented method for automated coding and testing of benefits, via program instructions stored in a memory and executed by a processor, the computer-implemented method comprising:

• receiving data pertaining to one or more benefits based on one or more insurance benefits contracts;
• creating one or more Benefit Plan Designs (BPDs) using the received data pertaining to the one or more benefits;
• mapping the one or more benefits from the created one or more BPDs with one or more pre-stored benefits;
• translating the one or more mapped benefits into codes or mnemonics;
• updating the translated codes or mnemonics into one or more claims platforms;
• generating one or more test claims and one or more expected results based on the one or more mapped benefits;
• executing the generated one or more test claims on the one or more claims platforms having the updated codes or mnemonics to generate one or more actual test results;
• and
• validating the updated codes or mnemonics by matching the generated actual test results with the expected results.

A computer program product for automated coding and testing of benefits, the computer program product comprising:

• a non-transitory computer-readable medium having computer-readable program code stored thereon, the computer-readable program code comprising instructions that when executed by a processor, cause the processor to:
• receive data pertaining to one or more benefits based on one or more insurance benefits contracts;
• create one or more Benefit Plan Designs (BPDs) using the received data pertaining to the one or more benefits;
• map the one or more benefits from the created one or more BPDs with one or more pre-stored benefits;
• translate the one or more mapped benefits into codes or mnemonics;
• update the translated codes or mnemonics into one or more claims platforms;
• generate one or more test claims and one or more expected results based on the one or more mapped benefits;
• execute the generated one or more test claims on the one or more claims platforms having the updated codes or mnemonics to generate one or more actual test results;
• and
• validate the updated codes or mnemonics by matching the generated actual test results with the expected results.