IncWorx designed a Microsoft Power Platform solution that centralizes claim intake, automates assignments, and improves workload visibility across the organization.
Dataverse Architecture
The solution begins with a structured Dataverse data model that anchors all core functionality. Custom tables store claims, referrals, team members, workloads, and assignment rules. By consolidating this data in one place, the model enables automation, reporting, and secure, role‑based access to claim information.
Claim Intake and Management App
Next, a cloud‑based Power App provides the primary interface for managing claims. Users can quickly add, update, and assign claims, while also linking multiple referrals to a single record for clearer visibility into related activity.
Administrators gain full control over operational settings, including:
- Adding, updating, or removing Examiners and Analysts
- Adjusting daily assignment caps by claim type
- Maintaining assignment rules without code changes
Automated Assignment with Power Automate
From there, Power Automate flows route claims automatically. Assignments are determined using claim type requirements, claimant state of residence, team availability from a Microsoft 365 Group calendar, and real‑time workload data stored in Dataverse. According to the client, these automations now handle roughly 70–80% of claim assignments without manual intervention.
Document Generation and Records Management
After intake is complete, another flow generates a claim summary PDF and uploads it directly to a SharePoint 2016 library. This step supports downstream processes and ensures consistent documentation for audit purposes.
Data Integration
To extend reporting and automation, a dataflow extracts metadata from an existing SharePoint 2016 library and writes it to Dataverse. As a result, metadata becomes readily available across the entire solution.
Future‑Ready Integrations
Finally, the architecture was intentionally designed to support additional automation scenarios. Planned enhancements include sending payment preference data to a bank API and logging transaction activity in Dataverse for auditing. Although these components were removed from the initial release, the architecture preserves them for future expansion.
This solution delivers a centralized claim intake process using Power Apps, Power Automate, and Dataverse. Claims are entered through a cloud app, assigned automatically based on rules and availability, and documented with generated summaries stored in SharePoint. The result is reduced manual effort, improved consistency, and better workload visibility.
