KM facilitates workload for insurers

Insurance companies are using knowledge management solutions to generate reports, manage content and provide better customer service.

Insurers often depend on third-party administrators to manage some or all of the claims process, including premium collection, enrollment and processing. Handling all of that work for its insurance customers meant that OwnerGUARD was at times dealing with anywhere from 1,500 to 2,000 pieces of paper in a 24-hour period, according to IT director Colby Giles. "We were handling hundreds of claims a day, which we needed to organize and file," he says.

The sheer size of the work was becoming too unwieldy. Another problem was that as the work volume grew so did the chances of staff misplacing files. "Humans make mistakes," Giles says.

The company explored some options, but the problem continued to grow until Giles had a conversation with a reseller of Xerox DocuShare. Giles explained some of the issues that OwnerGUARD was having with document management and learned that DocuShare could solve those problems. The installation went live in 2009, initially in the claims areas, and later OwnerGUARD expanded it to sales and marketing.

"The results were stunning," Giles says. "Even the hardest line detractors were up on the system within three hours. We started scanning in everything once it came in the door. We reduced our time to process claims about 60 percent to 80 percent. Our costs plummeted. Now people complain when it takes a couple of seconds to load a folder. Then I remind them about the pre-implementation days when they would have to find the person who had the folder and then look up the information, which would take at least 15 to 30 minutes. The application took what was not organized and put it into a clear and understandable structure."

By storing and sharing claims electronically, the company has reduced turnaround times by 47 percent, and now provides quicker customer service, increased satisfaction rates and saves more than $8,000 monthly on printing and toner costs.

DocuShare uses an ActiveX directory, so authorized users can easily find needed documents, and administrators have a simple way to manage permissions, limiting files to only authorized personnel. It facilitated the addition of new insurance dealers as well, reducing the signup process from a day to a few minutes, according to Giles. Since the initial installation, new versions of the software and additional experience with the solution have further enhanced the efficiency of the system, he says.

The next step will be to extend the DocuShare system to the last couple of areas of the company that have yet to adopt it.

Homesteaders Life

Easy retrieval of documents is critical in the area of pre-need (e.g., funeral planning) insurance, according to Carolyn Strawn, manager of imaging and new business for Homesteaders Life. The company works with 3,000 funeral homes in 44 states.

Any time a family had a claim, the funeral home had to check with Homesteaders Life to validate it, a process that was taking a day or more because the insurer was sorting through a growing mountain of microfiche and paper documents. "We were using archaic file storage methods," Strawn says. "We had so many paper files that we were running out of space." Typically any new claim took several hours to verify, leaving the grieving family and the funeral home in limbo.

So Homesteaders sought a document management system that would enable the firm to more efficiently serve its customers by eliminating the paper chase, and installed Digitech Systems' PaperVision Enterprise WorkFlow earlier this year.

All paper used to be routed through the office in the mail, a person would sort it into bins based on what it was (payment, change of address, etc.) and take the documents to the appropriate person based on the type of form. Now the paper comes in and gets scanned, which triggers the workflow and routes it to the right person automatically.

"We have better customer efficiencies," Strawn says. "It used to be that if an agent or  funeral home needed an authorization letter, we had to mail it to them. Now they can get it from us through the Web. Before, if they needed information, it would take us a few hours to get it to them. Now we can get them everything in a few minutes."

The solution has worked well enough that Strawn is looking to expand its use into different departments within the firm.

Generating reports

Horizon Blue Cross Blue Shield of New Jersey is one of the oldest BCBS companies, serving 3.6 million members across the state with various health insurance products. As the company's membership and product mix have grown, so did the need for data on which to base pricing, product features and other decisions, according to Mike Occhipinti, Horizon BCBSNJ director of informatics.

Even simple reports were taking days to run, which was unacceptable to executives. "We couldn't mine the data fast enough. We couldn't increase the efficiency of our people," Occhipinti says, adding that more people wouldn't have solved the problem either.

So several years ago, Horizon started looking for a knowledge management system that would help handle the mushrooming data from hospitals, physicians and other sources in order to produce reports more quickly. The insurer didn't have to look very far. Horizon had been using base SAS technology for about 20 years, so the addition of SAS Enterprise BI Server was a logical step, according to Occhipinti.

The solution's benefits emerged quickly. Occhipinti's team developed processes to enable authorized users to generate reports nearly instantaneously on their own, rather than submitting a request and waiting for someone else to run the report. That saves the insurer about $63 an hour. During its first three years of use, the system has saved Horizon about $1.2 million, Occhipinti estimates.

"This has become mission-critical for us," he says. "We're increasing our efficiency with the system from year to year."

The next step will be to expand the deployment to other departments within Horizon, many of which are still using Excel spreadsheets and similar tools to generate reports, Occhipinti adds.