Notes From the Field: Pet Insurance Claim Automation Solution

Capture, Workflow, ECM and ERP: Recipe for Automation

I had a great call with one of our customers the other day, a major pet insurance organization.   Keeping on my theme from my previous post (Capture+BPM: Pre, Midstream, Post), I wanted to share some details.  They have built an amazing solution to automate their inbound claims process.  Here is the lay of the land, pre-solution:

  • They provide pet insurance for their clients
  • Clients file claims that include invoices from vets, etc
  • They receive 6,000-8,000 claims per week.
  • Before the solution, everything was manual, received by fax, email and inbound paper mail
  • Data was being entered manually into their ERP
  • Documents were being saved manually, one-by-one into their ECM system
  • They have stringent regulatory SLAs for claim turnaround and response
  • New regulations required detail down to the line items on invoices filed for claims
  • It was taking 60-70 business days once a claim was received to process

Ah, the pain of manual processing.  Here is the teaser, after implementing the solution, they are now down to a 20 day turn around, and believe through further tuning they can get to 7.  So, they have taken the time to process down to a third or their pre-solution burden, and create an overall electronic system for claims processing.

Claims Workflow Queue
Processors Now Have a Digital Queue

The solution has made the process remarkably efficient, taking us from 70 days down to 20 to process a claim.

The Solution Architect

So, here are the components of the solution:

Ephesoft (Capture)Ephesoft’s intelligent document capture solution is used to capture and classify claims from inbound fax, email and paper files.  Through its advanced learning engine, it auto-identifies the type of document, splits multi-invoice PDFs, and then extracts the invoice information down to the line item data.  The documents and XML are then passed to the workflow engine.

extract claim data
Ephesoft Classifies and Extracts Inbound Invoice Data

There is quite a bit more that happens within the front-end capture.   This organization has enabled review and validation where they can actually review questionable documents before they get passed to the workflow.  This prevents bad data and documents from entering, and allows a checkpoint for insuring a complete claim package.  Rejected claims are passed back to the customer, with a note about what is required to complete the claim.

insurance claims validation
Ephesoft Automated Validation and Rejection of Claims

Finally, they have also implemented capture through Ephesoft web services.  Through a web portal, the customer can upload claim documents, and they are passed via web service to the capture engine to be classified and have data extracted.

document capture and OCR web services
Web Page Front-end For Ephesoft Web Services

You can learn more about web services for OCR and document capture here:  Web Services for OCR, Capture, Classification and Data Extraction

BPLogix (Workflow) – The Ephesoft data package is ingested into the BPLogix workflow engine, and then presented to claims processors for review and extensive validation.  With the new regulatory requirement on-line item invoice detail, this is a critical step.

workflow for claims
The Workflow Engine Receives the Extracted Data

Microsoft Dynamics AX (ERP)– once all the data is verified and validated, all the claim data is placed into the ERP for final processing and payment.

capture to dynamics
Ephesoft Data in AX

Alfresco (ECM) – Once all is complete, the claim documents are placed into their end resting place, and can be accessed at a later date if an issue arises, or there is a need for further review.

alfresco
Alfresco is The End Resting Place 

Great use of multiple technologies to automate a painful business problem.  Shows off the true value of document capture within workflow to add another dimension of process efficiency.  What do you think?  Any success stories to share?  Please comment.

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Top 5 HR: Processes Every HR Department Should Automate

Solving Top HR Concerns with BPM

As companies grow and look to attract and retain top talent, automating the people side of the business becomes top priority.  Improving your critical HR processes can help you drive digital initiatives and help transform your organization.   The right technology can drive efficiency, and allow more time for critical activities.

In world-class organizations, technology spend per HR FTE is higher (nearly 80%) due to greater use of process automation. These organizations are able to service 59% more employees per FTE and allow HR staff to devote more time to talent and business performance-related activities.

Unfortunately, HR leaders are faced with a broad set of challenges, as outlined below:

  1. Inability to integrate and adapt –  The average HR system is 5 years old, and can create challenges when looking to expand or integrate with other line of business systems.
  2. Prioritization – manual, inefficient paper-based processes have become a massive time sump, and pull attention away from more critical HR functions.
  3. Lack of knowledgeable resources – with IT project backlog, many departments are forced to take on more and more administrative responsibilities for their systems.  Keeping resources trained can be a key challenge.
  4. Difficulty in justifying new spend – HR departments have often found it difficult to justify new systems or additional IT spend.
  5. Adjusting for improvement – building business and tech requirements to drive excellence.
HR Business Process Management
HR Process Challenges

So, what are the key processes for HR to automate?  See the list below:

  1. Employee on-boarding and off-boarding – these processes are complex and cross-departmental.   Forms, IT accounts, payroll, facilities and more all need to be involved, and getting employees operation in short order is critical.
  2. Performance reviews – managing the performance review process can be difficult, and creating a standardized workflow and framework can lead to enhanced records management, timely promotions and a more productive workforce.
  3. Payroll processing – automating everything from expense reimburse to time tracking and management, digital process can insure minimal errors and timely payment.
  4. Recruiting and new hires – creating a digital workflow for interviewing and recruiting can lead to shorter approval times, and the timely on-boarding of top recruits.
  5. Policy management – reviewing and revising policies can be a pain, and the update process can be daunting.  Digital workflow can manage versions and changes, and make the process flow smoothly.

Want more information?  See the links below:

Free Book on HR Process Efficiency

HR BPM Top 5 Infographic

Full K2 Human Resources Information Page

Top 5 Finance: Processes Every Accounting Department Should Automate

Accounting Finance Workflows

Solving Top CFO Concerns with BPM

One of our partners, Protiviti, conducted a fantastic survey on “2016 Finance Priorities”.  The report is laden with some great information on what CEOs and CFOs deem important within the finance function.  Here is one of the key action items that came out of the study:

Action Item for Finance Leaders: Look for improvements and investments in people, process and technology that can result in greater speed, accuracy and efficiency within financial consolidation and close activities.

So why speed, accuracy and efficiency?  To understand, below is an outline of the top concerns for financial leaders:

  1. Improving Margins and Earnings Performance – Optimizing resources and the ability to better manage costs is a top concern.
  2. Cyber Security Risks – Managing and protesting financial data and controlling access to the ERP/Financial Systems.
  3. Strategic Planning – Creating streamlined predictable, standardized processes for planning.
  4. Periodic Forecasting – The ability to surface data from all systems of record.
  5. Budgeting – Using data for improved budgeting and decisions.
top bpm uses for accounting
Improving margins, cyber security, strategic planning, forecasting and budgeting are top concerns.

In these key concern areas, the demand for speed and accuracy continues to mount, and expectations grow without the increases in staff and budget.  So, implementing technology solutions to help is key for success, and helps to alleviate concerns.  So what are the top finance processes ripe for automation? Here are the top 5 processes:

  1.  Expense processing – providing an automated, rules-based process for submitting and approving expenses can provide a standardized, repeatable reporting mechanism for projections.
  2. Invoice Processing – with the majority of invoices still in paper form, automating AP is a key to faster payment (read early pay discounts), reduction in data errors and reduction in processing time.  Using an AP Automation tool like Ephesoft Transact for Invoice Scan and Capture can feed any BPM process.
  3. Capex Approvals – moving away from emailed spreadsheets in the CapEx process, and utilizing a managed digital workflow can provide insight, improved transparency and reporting capabilities.
  4. Budgeting – providing a collaborative, social environment for budgeting can lead to enhanced accuracy, and reduce departmental shortfalls.
  5. Internal Audits – simplified reporting and “visual” report tools can help smooth out the audit process, and reduce staff time required to comply with demands.

Want to read more?  See the links below:

K2 BPM and Workflow for Finance: Information and Transformation Page

Protiviti Finance Report

BPA Platform Value: The During (Part II)

BPA ROI and Value

Direct and Indirect Benefits from No/Low-code Platforms

This is part II of a series on the value, benefits and ROI of Business Process Application platforms, and the first post can be found here: BPA Platform Value – The Before.

In the previous post, we discussed the advantages to using a low/no-code platform to deliver apps faster to business users, and reduce the IT backlog.  Once the apps get into production, there is a huge impact on business performance, and this is where typical value is associated with efficiency and productivity.   There are two types of benefits that are provided in this phase, direct and indirect.  Below is a summary of both:

Direct and Measurable Benefits of BPA/BPM

  • IMPROVEMENTS IN EFFICIENCY AND PRODUCTIVITY
  • REDUCTION IN REWORK, ERRORS AND PROCESS FAILURE (QUALITY IMPROVEMENT)
  • REDUCTION IN REQUIRED STAFFING THROUGH AUTOMATION AND PROCESS TUNING
  • RISK MITIGATION
  • INSIGHT FOR CONTINUOUS PROCESS IMPROVEMENT AND ANALYSIS

Indirect Benefits of BPA/BPM

  • CENTRALIZED CONTROL AND MANAGEMENT OF ALL BUSINESS PROCESSES
  • ENHANCED COMPLIANCE
  • SIMPLIFIED AND CENTRALIZED AUDIT CAPABILITIES
  • IMPROVED COLLABORATION
  • GREATER ALIGNMENT OF IT WITH BUSINESS REQUIREMENTS
Return on investment for BPM
Examples of BPM/BPA ROI

In the above image, there are a few examples of some hard numbers on savings through process efficiency.  You can read more here:  BPM/BPA Case Studies.

Electronic Signatures to Drive Efficient Business: Silicon Valley Event

Docusign and K2

Come join K2, Docusign and Microsoft at the Silicon Valley Microsoft Technology Center for our lunch seminar:

EVENT ONE: Driving Digital Business with Electronic Signatures

Thursday, June 9, 2016  |  10:30 am – 1:30 pm  |   Microsoft Technology Center –  Mountain View, CA

Demand for digital signatures is growing at a rapid pace. Electronic signatures are just one part of a larger process. By integrating DocuSign’s Digital Transaction Management (DTM) platform with K2, customers can create end-to-end business process applications that require signing without ever leaving the process.

Join K2, DocuSign and Microsoft for a lunch seminar in Silicon Valley! This informative event will consist of three unique 45-minute sessions covering legality issues, integration points within the context of business process management, as well as showcase a live demonstration of these capabilities.

 

On-sight parking is free. Lunch will be provided. Please note any dietary restrictions in the appropriate registration field.

Register here: K2 and DocuSign MTC Event in Silicon Valley

Driving Digital Business with BPM and eSignatures

Efficiency and Speed with Digital Transaction Management

Creating a Digital Business
The Physical Office

The above photo of the office of the 1940s always amazes me.  How many icons of physical office workflow can you identify that are still in use today?  If you take a peek around your office, what do you see?  The file cabinet, the stapler, the 2-hole punch, the folder, paper documents, and God forbid a type writer.   We know these tools work, and they are time-tested, but they certainly come with a ton of drawbacks from an efficiency and speed of business perspective.  In a Forrester survey commissioned by DocuSign, respondents identified the top issues in dealing with analog processes:

  • Errors Due to humans and analog process – 50%
  • Cumbersome paper-oriented tasks such as scanning and document management – 44%
  • Difficulty collecting and managing documents from multiple sources – 42%
  • Difficulty administering and controlling documents over time – 39%
  • Lack of security over physical documents – 37%
  • Difficulty maintaining visibility on location and status of documents – 34%

With the highly competitive corporate landscape today, organizations just cannot conduct business at the “speed of paper”, and digitizing key operation processes has become mandatory.   One key area of focus has been Digital Transaction Management (DTM).  So what is DTM?  Below is the Wikipedia definition:

Digital Transaction Management
Wikipedia Definition of Digital Transaction Management

But DTM is just one piece of the pie when looking to drive operational efficiency.  DTM technologies, like DocuSign, can enable electronic signatures, but what about all the process pieces that surround getting a document ready to sign?  Adding a business process management suite with DocuSign integration can create a smooth process, and add the below value through standard BPM pillars:

  • Data Integration Layer – the pulling of information from existing line of business systems can help in the auto-creation of a signed document.  Take a contract process where account information is automatically pulled from CRM, instead of manually entering data.
  • Digital Forms – Forms can provide  consolidated work desk experience for document assembly, and provide for a review and approval interface.
Mobile ready electronic signature
Smartform eSignature
  • Workflow – a digital process can be standardized and managed through a workflow.  This can automate notifications, approvals as well as escalations during the document build, review and approval phases.  With the data it collects, it can also provide insight into the overall process.
electronic signature workflow
K2 DocuSign Workflow
  • Reports – Providing real-time process insight allows true management of any digital transaction process, as well as the ability to maintain historical data for audit and review purposes.

You can learn more on DTM and BPM at K2 and DocuSign Electronic Signature Process.

 

 

 

Cool Infographic: Forrester No Code Platforms

Best No Code Platform

No Code Platforms are the Key to Rapid, Agile Development

Some snippets from a recent infographic on no/low code application platforms.  Click on any image to see the full graphic.

Drag and Drop Applications

 

Agility with No Code Apps

 

Design apps with no code

Personal Banking Automation: Hours to Minutes

Financial Services BPM Automation

Financial Services and Banking Automation Through BPM

We released a great case study on First West Credit Union, and the customer achieved some amazing results through automation and smartforms.

“With K2, we can take the member process from hours – and multiple sessions – down to less than 40 minutes,” explained Arrowsmith. “It’s a much simpler and better experience for the member, and made it easier for member service representatives to get involved with new business banking opportunities.”

See the case and video here:

Banking and Financial Services Case Study with BPM

 

 

Financial Services: Top 5 Reasons to Modernize Your Processes

Business Process Management for Banks

BPM for Efficiency, Risk Reduction and Improved Security

 

…Gartner estimated that financial services firms spend between six and seven percent of revenue on IT. Yet on average, they only realize 43 percent of their
technology’s potential. This lag in technology is often due to size, complexity and legacy systems that limit agility.

See the whole article here:  Top 5 Reasons for BPM and Process Improvement in Financial Services and Banking

BPM Case Study: Bufetat Safeguards Children with K2-Based Processes

BPM and Case Management

Case Management System Speeds Up Delivery of Urgent Services

This is a great example of K2 BPM Case Management being leveraged to manage correspondence, documentation and overall case work.

“K2 helps us to work efficiently and provide urgent help for children in desperate need of accommodation, protection and support.”

Magne Tiegen, senior IT advisor, Bufetat.

Bufetat is a government agency in Norway that is the Office for Children, Youth and Family affairs.   They are responsible for child welfare and family counseling throughout the country.  They have over 5600 case workers processing over 7500 documents per month, and blackpearl has provided a consistent, standardized approach to managing cases, and enhance visibility on the overall process.

The full case study can be read here:  Bufetat Case Management and BPM