Jeopardy Abbreviations for Insurers

To celebrate the 35th anniversary of the Jeopardy game show, let’s play the category of Abbreviations for Insurers.

185_jeopardy

Me: Let’s start with Abbreviations for Insurers for $200, Alex.

Alex: The answer is: ECM

Me: What is Enterprise Content Management?

Insurers were among the early adopters of imaging and related software, but today many of those solutions are out of date, no longer supported or so customized and patched up that it takes too many steps to even get them to work. Workarounds abound. They leave data in siloes, can’t communicate with other programs and are vulnerable to security issues. Growth and innovation are stunted.

An ECM solution with workflow for insurers automates all manual systems and integrates with your current imaging and policy administration software. It brings efficiency, transparency, and cost savings with data security. Managing your workflow, the ECM digitally identifies, routes, maintains and manages all documents and data points. From scanned documents, application files, Web content, and multimedia content, to emails and industry standard ACORD XML files, an ECM solution integrates document, workflow, business process and record management with a single application that also integrates with existing policy administration and claims processing systems.

Me: Next I’ll take Abbreviations for Insurers for $400, Alex.

Alex: The answer is: CMS

Me: What is Case Management or Content Management System?

Insurers deal with millions of data points about customers in a variety of forms and formats. If these data points are siloed in outdated legacy solutions that don’t communicate with each other, insurers are only seeing a fraction of the customer information they need to open a policy or process a claim.

A comprehensive case management system is a platform that streamlines capture, case management, document management, secure file sharing, customer communication management, and workflow that integrates with your modern core system and business applications.

A CMS delivers document management of all types, including scanned paper documents, faxes, print streams, application files, electronic forms, web content, multimedia files, customer communications and emails.

It gives insurers the options to easily configure and integrate an unlimited number of content-enabled applications and solutions to manage content, processes, communications and cases across your entire enterprise with the modern core systems that run your business.

With a CMS, claims administrators or examiners manage all aspects of a claim, from early assessment to investigation to settlement. Insurers can collect, review and maintain the supporting documentation to assess the claimant’s coverage, validate statements and negotiate payment of claims. One integrated platform promotes access to all necessary information, task assignments and schedules, notifications and time-based reminders – bringing efficiency and lowering costs.

Me: Moving down the board, I’ll take Abbreviations for Insurers for $600, Alex

Alex: You’ve picked the daily double. The answer is RPA.

Me: I’ll make it a true daily double, Alex! (I’ve always wanted to say that). What is robotic process automation?

It goes by several different names, but RPA for robotic process automation is the main one. We’ve also heard the terms jet issue and automatic underwriting bandied about. It all comes down to the same idea: automating repeatable, rule-based processes, such as underwriting tasks, web services, and lookups – much of it in the name of giving consumers what they’re asking for, an online “Amazon-like” experience with insurance. Consumers are looking for mobile and 24/7 access with quick responses online.

Insurance workflows such as new business and underwriting, claims registration and processing and the creation of business and process analytics lend themselves to automation.

Software developers are working to automate these insurance tasks to address the demand for RPA in the marketplace. For example, they are adding chat bots that handle a variety of underwriting tasks. It amounts to “no touch” claims processing. They are identifying manual processes that can easily be automated to optimize processes, increase collaboration and reduce costs.

Many insurers are using automation to create efficiencies in the industry including smartphone apps, consumer activity wearables, claim acceleration tools, individual consumer risk development systems, online policy handling apps, automated compliance processing and more.

ImageSoft insurance solutions offer automation and operational efficiency to insurers and modernized content and process management. This includes digitizing existing processes and introducing AI to further streamline operations and reduce costs. We are leveraging front- and back-end technology to give customers a transparent and more personalized response. These technology advances capitalize on the wealth of data collected through tech devices and big data sources. The goal is to securely and efficiently manage cases, content and processes.

Alex: And there’s the buzzer. We won’t get to the rest of the categories today.

ImageSoft can guide you through the abbreviations for insurers to achieve the efficiencies and cost savings you need with industry-leading solutions for insurance. Gain automated workflows, improved speed and efficiency, reduced costs and proper compliance. ImageSoft is ready to help your company reap the benefits from all of the abbreviations.

Look for more information about our solutions for life and property and casualty insurance, plus workers’ comp.

Follow ImageSoft’s Insurance Solutions LinkedIn Showcase page to understand all the abbreviations.

Workflow – The Life of a Document After Review

This is Part 5 of 10 in the eFiling Blog Series, check out Part 4.

flintstonesAn image I use to describe eFiling without automated workflow is Fred Flintstone’s car: it looks automated; but somehow the driver is still doing all the work. From the filer’s perspective, once a document is filed, electronically or otherwise, the “processing” fun is over. But from the court’s perspective, receipt and acceptance of the document initiates an interconnected flow of activities, including identification, recording, and routing it across tasks, processes, and procedures through its lifecycle. This flow of activities is generally known as “workflow”.

Each workflow step has three basic parts. First, what it is. Second, decide what to do with it. Third, transport it to where the next step must be performed. With electronic documents, the third step obviously gets a lot easier, since the document need not be physically transported. But what about the first and second steps?

Consider for a moment the distinction between “Discretionary” and “Ministerial” decision-making. Discretionary decisions are those where the decision maker weighs the information and, based on his or her knowledge, experience, and authority choses which outcome or action would be most appropriate. Ministerial decisions, on the other hand, are those where the outcome is to be decided based on a set of rules known to the decision maker. A judge’s bail decision is discretionary. A traffic court referee’s determination of a fine amount, being based on a formula, is ministerial.

Discretionary decisions made by qualified people provide the “value added” in knowledge-based service industries like courts. In other words, that’s what the public is willing to pay for: well reasoned decisions.

When it comes to ministerial “decisions”, like where to send a document for the next step in a business process, while the rules may be complicated, following them does not require judgment; only knowledge of the rules.

Paradoxically, the more complicated the rules are, generally the more qualified is the person who must make the “decision”, both because that person is more likely to know the rules and because that person may be deemed more trustworthy to correctly follow them.

The result is that courts generally expend an enormous amount of their most valuable human resources on ministerial tasks that could be performed by anyone sufficiently versed in the rules. Meanwhile, those resources are considerably less available to provide the much higher value-added activities for which they are qualified. Indeed, in most courts, more time and effort goes into figuring out what to do with documents than is spent actually working with them.

Implementing eFiling, with or without also implementing automated workflow, certainly confers major benefits on the filers. From the court’s perspective, though, all other benefits pale before the benefits from implementing automated workflow.  A few years ago I wrote in a white paper:

“Where potential workflow improvements stand out, they tend to stand out impressively. Filing incoming mail, for instance, is a critical task requiring a high level of business knowledge. The individual performing this task must know how to “route” each incoming item (and often several items in one submission must be dis-aggregated and routed to separate locations), sort them into piles, then assure they are accurately fed into whatever distribution process is used to physically move them. In a system with properly implemented workflow, the document (usually self-identifying), once entered into the ECM system, will be automatically routed to the correct place.

“The first key savings is the time of the knowledgeable staff who no longer have to individually assess and route each document. Next is Elapsed Time savings: delivery can go from days or weeks to minutes. Then there is the savings not only of the reduction of lost and misrouted documents to near zero, but the elimination of the need for redundancies and safeguards that are commonly in place to deal with those errors when they inevitably happen in the paper document world.”

Short-Term Payback and Long Term Gain from Transitioning to a Paper-On-Demand Court, Jeffrey N. Barlow, 2011.

Yes; eFiling can be implemented without automating workflow. But it makes no sense.

Coming up next: Blog 6 of 10: eFiling Blog Series – Data Centric eFiling

 

Progress

One of the interesting factoids about progress is that in the nineteenth century, ninety-seven percent of the population was engaged in producing and distributing food for everybody.  By the mid-twentieth century, the figure was down around three percent.  Note that the population during that time had more than quadrupled.   However you look at it, an enormous amount of resources have been re-directed from the basic task of feeding the population.

There are many ways to look at and value (or decry) this phenomenon.  Here is one:  Those resources have been freed up for other things, including space exploration, medical advances, increased education, individual family housing, more flavors of ice cream, and on and on.  Granted, the world today faces serious challenges.  Nevertheless, it is indisputable that overall quality of life and standard of living have improved during that time across the board.  And, we don’t have ninety-seven percent of the population as unemployed farmers.

I make this observation as I consider today’s courts and related justice systems as they move toward transformation from physical documents and manual record management to Electronic Content Management (ECM) and a paper-on-demand court model.

Historically, a huge proportion of court resources have been dedicated to document and record management.   There have always been many more record clerks than judges in most courts.  Skill requirements included document processing, file creation and assembly, file storage, file retrieval, file transportation, copying, file security, etc.

As courts move forward, they are finding less and less need for those basic, manual skill sets.  More and more, ECM systems free up the resources to undertake higher-order tasks such as direct judicial support, customer service and specialty court functions.  As time goes by, this trend will only accelerate.

None of this is to say that the path is either straightforward or easy. Generally speaking, when courts make the transformation from paper documents to ECM, they must initially do so largely within the context of existing resources and infrastructure.  That means that the courthouses, offices and often related justice agencies, are usually designed and located with physical document management in mind.   A significant number, if not a majority, of the support staff are primarily trained and experienced in dealing with and managing paper documents and files.   While internal processes can often be adjusted as part of the implementation, in many cases inter-agency or customer-facing processes must remain or at least “imitate” the old, paper-centric processes.

Following initial implementation, however, these “legacy” resources and infrastructure will, over time, give way to resources that are positioned to fully utilize the capabilities of the new systems.  Staff previously trained in processing of paper documents and files will be re-trained and re-assigned.  Work spaces and physical plant will be re-located and re-furnished; and eventually, as new facilities are built, they will be appropriately designed without the encumbrances of the old systems.  Newly recruited staff will bring skill sets directed toward the higher-order activities.

As any veteran of paradigm-changing technology implementations knows, the down-stream adjustment is neither straightforward nor easy.  As much as it seems that once the seriously challenging effort to implement a new system is completed the organization should be able to sit back and coast, that just isn’t the way life works.

So, for those who expected all rainbows and lollipops, sorry to disillusion you.  But I don’t bring this point up just to be a “Debbie Downer”.    The point is that it is really easy to get caught up in the intensity and immediacy of implementation and be sorely tempted to use whatever workarounds are expedient, without considering the longer-range world into which you are moving.   When planning for and working through initial implementation, time and effort taken to look beyond the immediate “sturm und drang” to plan for the future, when the relics of the old paradigm have finally been replaced will pay big dividends.

Once this process has run its course, the level of service provided by the courts and wider justice system will be considerably greater than anything possible in the old, paper-centric world.   Future generations will be astounded when they stumble across figures showing the percentage of resources courts used to devote to document management in “the old days”.

60_progress