Meaningful RE-use

Posted by Mark Brousseau

Jim Thumma, vice president of sales and marketing at Optical Image Technology, says insurers can pick up the pace in underwriting, claims and more by re-using data meaningfully:

Recycling is vital as society seeks solutions for sustainable living. For insurers, however, the relevance of recycling lies in reusing valuable information meaningfully. Consider the information you collect from policyholders and others, and how many decisions are contingent on what they supply. How can you extract more value from what you have?

Understanding information value
Technology today is about building bridges so insurers can work efficiently, provide quality service, and compete successfully in a challenging marketplace. Trying to bridge existing gaps in the information flow isn’t new; insurers have discussed it for years. Business process management software tied to ECM is an effective enabler, but technology alone doesn’t guarantee meaningful use. Typically, gaps arise from a failure to understand—and manage—our information and its multiple uses.

Defining meaningful use
To make astute decisions, information must be accurate and timely. Knowledge workers need it whether they’re in the office, traveling, or visiting clients. If you want to capitalize on information value as it’s harvested, it should be captured digitally at the source and shared efficiently everywhere within your business where it could influence processes or outcomes.

Ideally:

Incoming mail, data captured via online forms, and email attachments launch pertinent business processes and advance appropriate actions.

Pertinent policyholder data feeds automatically into billing software as new policies are approved and issued, expediting billing and ensuring accuracy.

Data captured in rules-driven voice mail and faxes launches appropriate business processes.

For information to be worthy of reuse, it must be accurate and readable. Front-end capture makes it instantly useful, restricting human involvement to tasks requiring analytical thinking and decisions. Even the smartest knowledge workers are prone to mistakes when information must be gleaned, copied, or re-keyed.

By implementing rules-driven business process management software as part of your content management strategy, accurate information can be re-used logically, promoting actionable intelligence. Many clients of well-deployed ECM/BPM solutions that re-use meaningful information wisely underwrite upwards of 35% more policies; cut claims turnaround from weeks to days; and handle 30-40% more work using the same staff, increasing profitability significantly.

Discovering where meaning lies
Virtual communication can connect people and processes by enabling the seamless transfer of information to every place it has value. Yet like physical bridges, virtual conduits have requirements that plead to be satisfied. You need to:

... Understand the types of information that flow into your company ― which data is critical, in which business areas, and for which specific decisions.
Know all of the sources where that information is found (email, documents, eForms, faxes, handwritten correspondence, voice mails, images).

... Discover every place within your organization where the information has value.
Identify individuals who require access.

... Ensure the business rules you establish with your enterprise content management (ECM) software reflect your governance policies and controls.

Swift, seamless communication doesn’t happen by accident.

Masterminding meaningful use with BPM and smart integration

Consider the interrelationship between policy administration, claims, and accounts payable in a standard claim submission that is aided by a well-planned ECM and BPM implementation and integrated across all business areas:

Selma, a policyholder, returns from work. Someone has broken into her home, stealing valuable jewelry and small appliances. She contacts her agent to submit a claim.

Agent

· The agent completes the First Notice of Loss (FNOL) and faxes it to the insurer. The fax is imported automatically into the ECM system and key data is used to automatically index the document for immediate, secure retrieval. BPM assigns a unique number to the claim and sends the FNOL to the appropriate reviewer based on information detailing staff roles, current workloads, and schedules.

Claims reviewer

· The assigned reviewer sees the job as the top task in his queue. He clicks on the link to the FNOL and views policyholder’s information, selecting the policy pertinent to the claim. The next click packages the documents and sends them for supervisory review along with the appropriate, automatically generated email message.

Claims supervisor

· The supervisor views the policy via a link in her email. She compares it to the FNOL, verifies the match, and forwards it to the adjuster.

Adjuster

· The adjuster adds relevant photos to the file. He requests police reports. As they arrive, they are imported and indexed. When the file is complete, BPM packages the field survey, images, and reports, linking them to the policy and FNOL, and the folder is returned to the supervisor.

Claims supervisor

· The supervisor receives email notification the claim is ready for final review. She approves it for payment.

Accounting

· Relevant claim information is extracted electronically (name, policy number, contact information, deductible, payment due) and pushed by BPM into the A/P software, ensuring accuracy and expediting payment.

Customer service

· The claimant calls to inquire about the claim’s status. The answering service determines from voice response which claim is in question. The call is routed appropriately. Support views the up-to-date claim status, assuring the customer the check has been sent and providing details.

By integrating policy administration, claims, and billing with ECM and using BPM to orchestrate the flow of information wherever it’s needed according to business rules, Selma’s claim is processed quickly and cost effectively. Work is more efficient. Resources are used wisely. Fewer mistakes are made. The company gains financially and reduces its risk to legal exposure and unhappy clients.

Evaluate your routines
Contrast this with your everyday routines. How many opportunities for meaningful use are overlooked? How much time is wasted? How many customers are underserved? How much money is lost because of inefficiency?

Are the shortcomings acceptable, or are you ready to change?

Take steps toward improvement
Whenever you collect information from applicants, policyholders, staff, or third parties, it likely has value in more than one place. Analyze and understand the value of your business information. Use ECM and BPM to maximize the meaningful use of it. Your business will profit measurably.

What do you think?