5 Common Myths About Managing Content Within Your Claims Management System

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5 Common Myths About Managing Content within Your Claims Management System


Today’s Agenda

Introductions Industry Pressures 5 Common Myths Overview of IBM Case Management Q&A


Introductions

N.A Industry Software IBM

Will Sellenraad Vincent Price

20+ years of insurance expertise previously holding executive level positions at Willis and Kemper. Today Vincent is helping insurance providers utilize the correct technology to meet their business objectives.

15+ years helping insurance carriers transform claims, underwriting, and policy administration processes to increase customer retention, agent loyalty and user productivity.

Principal, Insurance, Pyramid Solutions, Inc.


Poll-

What are your content challenges when processing a claim?

1. Finding the content within your databases

2. Determining which document is the correct version

3. Knowing when content arrives

4. Having the ability to efficiently process content


Industry Pressures

Commoditized Market with Empowered Customers Requires a Focus on Customer Service

Shorten Processing Time With:– Fewer Customer Touch Points

– Increase Data Accuracy


5 Common Myths

“…All you need is an industrial strength content repository, with a link in your SOR to access the content …”

1. Content can be easily added to the claim from any source.

2. Incoming content can be immediately acted on.

3. All users have access to a claim and policy content any time they need it.

4. A Claims Management System provides a one-stop shop to all content and data.

5. The claims dept. is enabled to take control of their processes and content within a Claims Management System.


#1“Content can be easily added to the claim from any source.”


Myth #1: Content can be easily added to the claim from any source.

Content doesn’t always arrive in a format that can be added into your system.

Content can/does come from third party systems.

It isn’t always easy to identify which claim(s) the content belongs to.

Disparate input methods/paths can lead to missing claims documents.

Exposed


#2“Arriving content

can be immediately acted on.”


Myth #2: Arriving content can be immediately acted on.

There is a delay between when the content is received and when it is available within the Claims Management System.

Content is not always accurately associated with the right Claim.

Notification of new documents being received often requires customization.

Multiple documents may be associated with a single activity.

Large documents may need to be split among several workers.

Exposed


#3“All users have

access to a claim and policy

content at the time that they

need it.”


Myth #3: All users have access to a claim and policy content at the time that they need it.

Challenge providing access to users

outside of Claims process.

Accessing content based on a business need (e.g. all documents related to Policy xyz across Policies and Claims).

Multiple copies of the same information is used across the claims department.

Can other lines of business and auditors access the needed content?

Exposed


#4“A Claims

management system provides a one-stop shop to all content and

data.”


Myth #4: A Claims Management System provides a one-stop shop all content and data.

Claim documents are siloed in the Claims Management System and are separate from other content and processes.

Document details are only available in the Claim Management System, limiting the ability to find documents.

Requires a Claim Management System license to view content.

Document access and security is limited to people with access to the system.

Exposed


#5“The business is enabled to take control of their processes and content within a

Claims Management

System”


Myth #5: The business is enabled to take control of their processes and content within a Claims Management System.

Changes to the Claims

Management System are costly and time consuming.

Heavy dependence on IT to improve Claims processes.

Delays in reacting to changing business needs.(e.g. a storm requires reprioritization of work)

Exposed


Poll

Which myth does your organization fall victim to?

1. Content can be easily added to the claim from any source.

2. Incoming content can be immediately acted on.

3. All users have access to a claim and policy content any time they need it.

4. A Claims Management System provides a one-stop shop to all content and data.

5. The claims dept. is enabled to take control of their processes and content within a Claims Management System.


Case Study


The Solution• IBM Datacap & Case Manager, Enterprise ECM• Pyramid eXpeditor for Claims• Manage all content within Guidewire• Guidewire UI with folder based view of all content • Guidewire actions based on document arrival• Migrate legacy ECM documents into Case Manager

A Fortune 500 P/C Insurance CompanySignificantly improved efficiency and competitive advantage

The Challenge• Enterprise ECM platform won’t scale • Maintain and expand JD Powers lead in

Claims• Eliminate “jumping” between

applications• Reassign work for workload balancing

between branch offices• Increase worker productivity, reduce cost

Benefits• Reduce time to process a Claim by 30% or more• User can quickly review all relevant documents within Guidewire• Trailing documents alert Guidewire Claims adjuster upon arrival• Role based document view prevents unauthorized viewing• PIX solutions increased worker productivity• Tools to practice continuous process innovation


IBM Enterprise Content

Management


IBM Enterprise Content Management

ECM.PYRAMIDSOLUTIONS.COM | 2222© 2015 IBM Corporation

Doc ID Estimate

Classification/OCR with Datacap

Case ManagementClaim documents:Claim, accident report, damage report, repair estimates, photos,

• Are all required documents present?

• Are all required fields and signatures present?

• Are proper index values assigned to each document type for search and retrieval?

• Knowledge workers have all documents and data required to move the claim through the approval process swiftly and accurately

• Scan with MFPs, portable scanners, input fax, email and attachments

• Mobile capture enables claims adjusters to input immediately

• Document request prompts make it simple

• Secure log-in and encryption provide security

Document Conversion

Core Insurance Solution With IBM ECM

Document Storage On Premise or In the Cloud

• Content can be placed on premise or in the cloud based on the customer requirements

Additional document requests

Analyst requests further documentation,Additional input


23

Forrester, “Next Generation of Knowledge Worker Processes Will Dominate Enterprises”, Oct. 2010

Dynamic Case Management

“A semi-structured but also collaborative, dynamic, human, and information-intensive process that is driven by outside events and requires incremental and progressive responses from the business domain handling the case. “


IBM Case Manager

Decision-centric

Operational Decision Management

Automate repeatable, routine decisions at scale with the fidelity of an expert

Process-centric

Business Process Management

Manage how work gets done across the spectrum from structured to ad hoc tasks

Content-centric

CaseManagement

Driving better outcomes by putting business content to work


IBM Case Manager

A case is opened

Information Workflow

Knowledge workers

Case closedüdelivering the right content

at the right time

to make the right decisions


IBM Case Manager is the leader

26

“The largest ECM vendor in terms of market share and total content revenue, IBM has an increasing focus on high-value solutions.”

“IBM will drive leadership in analytics in the dynamic case management market.”

Rank: Leader

Rank: Leader


Q&A


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5 Common Myths About Managing Content Within Your Claims Management System