Data, Data Everywhere . . . (Oops insert card for license fee before proceeding!)

You know you need to capture workforce and process intelligence for your organization, and you think you’ve found the perfect software solution for the job. Now you need to decide how much data you are able to mine. “More data” is by far a better option than “less data” when venturing into the world of Artificial Intelligence (AI), automation and Machine Learning. With the right volume of data, you are able to get a more accurate picture of what is actually happening in your organization, what variances may exist in your processes and where the real opportunities for improvement lie.

The decision of how much data to collect will not only define the quality of data for your analysis, but it will likely impact your licensing agreement too. With the sheer magnitude of options for technologies, the decision can be overwhelming: SaaS, freemium, on-premise, user pricing vs. server pricing, etc. Interpreting licensing options shouldn’t get in the way of making the right decision for your business, but capturing all the data you really want and need may drive the project cost up and bury the ROI before the new project ever gets started. 

We know your pain and decided new pricing models are needed in this arena.

The traditional approach for data and process mining solutions was to tie pricing to the volume of data, collection points, robots or data storage utilized. Unfortunately, this approach can result in collecting less data. Decision makers may need to reduce costs, or they may want to avoid the inconvenience of dealing with PO’s and updated license agreements whenever more data needs to be captured. Recently, one of our partners, PAFNow, announced a new partnership with Microsoft Power BI in which they provide free access to mining data. It’s very innovative and helpful for companies who are learning how process mining can impact their organization. (You can find a link to their announcement below.)

OpenConnect has also been working with our customers to learn how best to provide value, at a fair price. We’ve done this while providing a more flexible, almost unlimited, path to collecting data for our WorkiQ and DiscoveriQ solutions. Our goal is to let our customers capture as much data as they need. That can be from 1 or 1000s of desktops, data from RPA robots and data from other sources such as Citrix servers or Mainframes. Regardless of how many processes, activities, tasks, cases or collection points are used, you now only license the people that need to analyze and use the data. It’s that simple. You get to focus on ensuring you have the right data for your analysis without limiting it. With basic quick start packages, you can get your workforce intelligence and process intelligence started next week and begin revealing insights for tomorrow’s workforce.

We would enjoy discussing how to make sure your ROI is achievable and is something you can brag about to family, friends and peers at industry events. Connect with us here https://www.openconnect.com/contact/ to schedule an intro to our quick start and scalable pricing models.  

Next up, we’re going to fix airline pricing! I hear robots fly for free except on Tuesdays in months that have r’s in them.

PAFnow press release: https://pafnow.com/en/2019/03/28/paf-globalizes-and-democratizes-process-mining-free-of-charge-for-all-microsoft-power-bi-users/

 

Process Discovery Can Change the Pace of Success for RPA

Robotic Process Automation (RPA) has been a major topic of interest over the past few years. It isn’t a new concept, but with the advent of new delivery options, the results that can be achieved are continually improving. In order to improve any process by making it more efficient or lowering its operational costs, though, we must first understand how it currently works. That’s where process discovery and documentation are key to your overall success.

Let’s use common analogy – automotive performance. Does improved performance mean you want to go from 0 to 60 mph quicker, improve handling or achieve better fuel efficiency? You first need to understand what better performance means to you, and then you can take inventory of what you already have. At that point, you can put a plan in place to improve your vehicle’s performance. If you want more horsepower, you wouldn’t replace the tires. Likewise installing a new cold air intake won’t upgrade your car’s handling. If you rush out and buy something you think you need, without understanding what you have, you may end up with an expensive credit card bill and the same old car.

It’s no different when scaling your RPA practice. To implement an effective automation solution, you need a strong understanding of your end goal, as well as a good handle on your current situation. UiPath has a great RPA Adoption Model addressing a strategic Top-Down approach versus a task-level Bottom-Up approach and when each makes sense. Leveraging the right analysis and documentation, in the form of process mining, process intelligence and Artificial Intelligence (AI), can help achieve your desired performance and at a faster rate, resulting in a very powerful automation solution.

At OpenConnect, we think we have the secret sauce to improve any process — large or small, basic or complex. Even if you don’t know where to start in your automation journey, we can help. It starts with accurately capturing the right activities and tasks being performed. You can get log data from larger packaged software like SAP and Salesforce. However, if you aren’t including desktop tasks, you are not seeing the full automation opportunity. Using WorkiQ we capture EVERY task that occurs on the desktop, and we do it natively. It’s not an experiment or done it a lab setting. The tasks are captured where your people are doing actual work without interrupting the user. It doesn’t capture how the work is supposed to be performed, but it captures how it is actually being completed. Once this data set is collected, we port that to process mining solutions like PAFnow to execute a deep analysis on all data sets and process possibilities. We can also send it to our DiscoveriQ tool for quick process documentation outputs of known process activities and variations. By using analytics to help design the outcome you are able to produce a result that improves your speed to ROI, overall cost savings and the final outcome.

As you consider your automation drive, remember to take a look at your current processes and activities to chart your path forward. Once you have that in your sights, 0 – 60 in under 6 seconds is right around the corner.

Top Three Reasons to Consider Workforce Intelligence for Distributed Workers

The evolving nature of work continues to change at an amazing pace. While artificial intelligence, machine learning, and robotic process automation (RPA) continue to push the bounds of a back-office workforce. The fact remains, a large number of workers will be engaged in back-office operations for a long period of time. Recruitment, retention, and training remain a strategic aspect of building strong brands. With the unemployment rate at an historic rate of 3.9%, this becomes even more difficult.

To remain competitive, companies are getting creative with flexible benefit programs. One such program that is becoming more popular is work@home or flex-scheduling. The blend of on-premises, work@home, outsourced (BPO), and, frankly, just a geographically distributed workforce provides a competitive advantage. The question then becomes: how do you measure and size your workforce in a distributed environment? The answer: workforce intelligence.

Here are the three biggest benefits of using workforce intelligence with your distributed workers:

  1. It can help you spot process inefficiencies — in real time — and lead to more productivity and lower labor costs.
  2. It can help you better understand what motivates your team, so you can implement programs that increase employee engagement.
  3. It can help you take the guesswork out of staffing, making long-term forecasting easier and more accurate.

With any team, success depends on your ability to measure, adjust, and improve. It’s no different with your work@home or distributed work teams relative to your on-premises processing teams. Consistent measurement and analytics, regardless of work location or work hours, are important. OpenConnect’s WorkiQ can give you the real-time insights you need to make meaningful management decisions and maximize your company’s productivity.

How RPA Gives You the Flexibility You Need

Over the past few years, the healthcare insurance industry has been the focus of a tidal wave of changes — regulations, new market challenges, open enrollment, labor challenges with business process outsourcing, and a significantly more complex operating environment. More than ever before, healthcare insurance companies can benefit from robotic process automation (RPA). Interestingly, the question we get the most is: “Where do we start?”

While we and other vendors can help you discover the processes in detail (for example, please see our complete-package solution), perhaps we can start with identifying the operations areas that will net the most significant ROI. OpenConnect has been helping healthcare insurance companies automate for over 12 years, and here are the top four areas where we have seen our customers derive the most significant benefits from automation:

  • Claims adjudication
  • Enrollment and membership services
  • Provider data services
  • Revenue cycle management

Each of these operations has a complex need for both human and robot interaction, due to the challenge of data management. If the data is incorrect or not normalized, core systems begin to create exceptions, which drives up the need for more human labor interaction. Even worse, the patient experience suffers.

For many companies, these menial tasks and other routine data-entry processes continue to be handled manually. The cost for maintaining that status quo can be steep: it costs $57,725 to hire and employ just one data entry worker (this figure is based on data gathered from the U.S. Bureau of Labor Statistics and the Center for American Progress).

Working the plan — but staying flexible

Let’s consider the game of football (for our friends outside the U.S., we mean what you call “American football,” not what we call “soccer”). In football, the quarterback’s job is to direct his team down the field. And, although the team has a game plan, the coaching staff isn’t afraid to have the quarterback “call an audible” to adjust to the opponent’s constantly changing defensive “looks.” Using his vision of the whole playing field, the quarterback’s situationally responsive selection could be either running the ball or throwing a pass – each of which may deliver a successful outcome.  In fact, the so-called “run/pass option” play has become increasingly popular, precisely because of that flexibility it gives teams.

Much like a football team’s need to change things on the fly as they see new and shifting challenges looming ahead, healthcare insurers also need the flexibility RPA can provide in their strategy. While claims tend to be the first focus, we see customers identify sub-processes every day that can change the outcome of the game — in this case, a correctly paid claim. Think back to the “top four areas” we identified earlier. We have many customers who are attacking claims adjudication and seeing trends in provider data inconsistencies. This new knowledge allows our customers to pivot and begin pointing robots at cleaning provider data, which results in improvement to all claims adjudication rates.

This is the benefit you achieve when robots are implemented based on detailed analysis performed before the implementation. Even when employees are buried in manual data entry work, they’re hard-pressed to raise the level of the team’s or company’s performance. Starting an automation strategy opens the lens to “calling audibles” for your operational performance. Just like a team that sticks to a game plan even after it’s become clear the other side has overcome it, an annual business plan that involves throwing more human labor and overtime at a problem doesn’t work anymore.

So, as you embrace automation for all the benefits it can and will bring you, be sure to choose not only a vendor but also a plan that will give you maximum flexibility to meet your challenges — both the ones you can see now and the ones you can’t quite see yet.

This Is What Success Looks Like…

Last week I had an opportunity to present alongside Sally Miller (VP of Operations at CareFirst) at the Healthcare Claims & Services Conference in Las Vegas.

The basis of the presentation was to review how CareFirst is continuously improving claims operation through the usage of analytics and automation (robots). While I can’t publically detail CareFirst’s outcomes, I will say the results they are receiving are very impressive. From a broad perspective, my observation is that CareFirst has taken action in three key areas that are leading them to exponential operational improvements.

Organizational Alignment

Sally and team are aligned to identify and execute operational improvements. Utilizing OpenConnect analytics, a team evaluates and prioritizes high ROI automation projects.

This team then documents the requirements and hands off to the robot scripting team. Then an operation team pushes the robots into production. This conviction to continue process improvement allows CareFirst to maximize investment in technology and people with a high rate of return.

Focus on high value automation

Once edit codes have been ranked, the teams focus on requirements and execution on the edit codes that will increase First Pass Rates (auto-adjudication). Using this value-lens, CareFirst operations can utilize robots to guide organizational improvement across the enterprise, and ultimately deliver both financial and service-level results back to their members and providers.

Not a single platform

Many payers only consider automation within their core system. However, the CareFirst team utilizes multi-platform robotic process automation to solve enterprise-wide challenges. This approach has led them into automation that includes mainframe, web services, and other types of platforms. They are currently working to automate new opportunities such as cash receipts, member/physician look up from third party applications, and other Blue Association applications.

We appreciate CareFirst as a customer utilizing OpenConnect solutions for analytics and automation. I for one am very impressed with their organizational approach for business improvement. Well done!

Getting Away From Self-Reporting

Have you ever felt very satisfied with the completion of a workday or project just to realize you still need to document your time and/or items of work completed? Looking for more productivity from your team, but still requiring them to provide mandatory self-reported time/work sheets?

Many back office operations, particularly in Health Plans, have an excessive amount of self-reporting. Still using spreadsheets that are difficult to roll up to a group level and take a lot of time to insure individual inputs are correct is an amazing time killer. Others use simple web based applications which rely on accuracy of the reporter, while believe it or not some plans still use paper, pencil and stop watches.

Self-Reporting is a root cause of several common operational deficiencies:

  • Too many costly work hours spent completing forms and combining spreadsheets
  • Consistency in the definitions of work across multiple groups and individuals lead to errors
  • Accuracy of data is dependent on those inputting the information, again leading to errors or misrepresentation
  • Without real-time data; managers cannot make decisions to impact inventory quickly

Using automated capture and reporting of work streamlines operations and provides real-time data. Take a look at WorkiQ as an example using desktop analytics. While visiting our information take a swim through our Savings Calculator to see how much your operations might benefit from eliminating self-reporting.

CareFirst and OpenConnect to Present at Health Plan Claims Conference

 

 

For Immediate Release

September 17, 2015

 

Contact: Michael Cupps

(972) 523-6690

mcupps@openconnect.com

 

CareFirst, OpenConnect to Discuss Improvement

of Claims Auto-Adjudication

CareFirst Vice President of Large Group Operations to serve as featured speaker at the

Health Plan Claims & Service Operations Conference

 

Michael Cupps, OpenConnect Senior Vice President, and Sally Miller, CareFirst BlueCross BlueShield (CareFirst) Senior Vice President of Operations for Large Group Strategic Business Unit, will serve as featured speakers and panelists at this year’s Health Plan Claims & Service Operations Conference on October 26, 2015.

 

Cupps and Miller’s panel will focus on key areas in which analysis and automation can improve the claims process by reducing costs and decreasing pended claims. Miller will speak to CareFirst’s success in significantly improving operations through the identification and utilization of previously uncaptured data, and the capacity to deploy software robots to process work.

 

“The opportunity to improve operations first pass rates and to demonstrate significant savings for health plan claims is a prime target for RPA,” said Cupps. “Utilizing analytics to target the most costly claims or edit codes, then automating them allows organizations – as CareFirst has demonstrated – to optimize human capital, improve customer service and lower administrative costs in an increasingly competitive market.”

 

WHAT: Health Plan Claims & Service Operations Conference

 

WHO: Sally Miller, CareFirst Vice President of Operations, Large Group Strategic Business Unit and Michael Cupps, OpenConnect Senior Vice President.

 

WHERE: Westin Las Vegas Hotel, 160 E Flamingo Rd, Las Vegas, NV 89109.

 

WHEN: Monday, October 26 – Tuesday, October 27, 2015. Miller and Cupps will speak on October 26 at 1:10 p.m.

 

CONTACT: Michael Cupps at (972) 523-6690 or mcupps@openconnect.com.

Advanced WorkiQ Training

OpenConnect has introduced new advanced training packages that enable our customers to maximize the value of their WorkiQ investments.

WorkiQ, the first desktop analytics suite designed specifically to measure back office operational intelligence, is fast becoming a standard in claims, enrollment, and membership in the largest Health Plans in North America.   Our customers are seeing, on average, a 3-5 month payback in savings and productivity efficiencies.

The new advanced training programs are designed to support growth into new teams or business units, enhancing the usage of the data through new reports and dashboards.   The training is provided either on-site at a customer location or it can be delivered virtually for remote teams.   Below is a brief description of the new courses.

WorkiQ Advanced IT Training (1 day)

The Advanced IT Training provides more in-depth server maintenance and troubleshooting tips including database queries and health checks.

WorkiQ Advanced Admin Training (1 day)

The Advanced Administration Training goes deeper into employee management and trouble-shooting, covering license management, Gatherer status checks and using Gatherer Groups to separate Gatherers for troubleshooting or testing new features.

WorkiQ Advanced Report Training (1 day)

The Advanced Report Training takes WorkiQ reporting to a new level, with instructions on how to add external reports and build custom web pages that can be displayed through WorkiQ, as well as tips on using the Chart Wizard and Datasets.

WorkiQ Mentoring (1 day)

WorkiQ Mentoring can be used for more personalized, one-on-one training on any topic or area of WorkiQ.

WorkiQ Process Training (1 day)

Process Training teaches WorkiQ Administrators how to define and implement Processes and view the results of the Process Data through WorkiQ reports.  Process Training includes use of the Desktop Designer – WorkiQ’s tool for designing panels for Processes.

 

If your organization is ready to enhance your usage and knowledge of WorkiQ, please contact your Account Executive for pricing and availability.

 

OpenConnect at AHIP Institute 2015

OpenConnect is excited to sponsor and exhibit at  AHIP Institute 2015! There is an impressive line up of excellent speakers and topics. We look forward to spending time with our customers and potential customers in these sessions and throughout the exhibit hall.

We will be at booth #1149 on Wednesday 6/3 Noon to 7pm and all day on Thursday 6/4. Stop by for a demonstration of desktop analytics and ask about automation solutions. We can share how our Health Insurance customers are seeing significant payback and benefits using these tools.

Join us for southern hospitality and country music with the great Martina Mcbride on Wednesday evening! See you in Nashville!

 

Analytics for Insurance Conference – Canada

OpenConnect’s Michael Cupps to Discuss the Future of Technology and Data Capture at the Analytics for Insurance Conference

Mr. Cupps will be a featured speaker at the Analytics for Insurance Conference session titled “Improve claims processing by identifying & understanding ‘dark events’”

Dallas, TX, May 4, 2015 – OC WorkiQ, a leader in workforce intelligence and business process analytics software and services, today announced that Senior Vice President Michael Cupps will be a featured speaker and panelist at the Analytics for Insurance Conference, May 11 – 12 in Toronto, Canada. Mr. Cupps will focus on how analytics can make the claims process more efficient and transparent.

The claims handling process involves large amounts of data, but unfortunately much of this data has historically not been tracked and measured in a meaningful way. Emerging technologies and the use of analytics that are capable of tracking this data are crucial to the future of the claims handling process.

Prior to the panel discussion, Mr. Cupps will deliver a presentation on understanding Dark Events, which are discrete actions that occur in the processing of a claim. The panel discussion will cover a number of key areas related to the role of analytics in the claims process. The additional capabilities that analytics enables – from developing new predictive models, to providing more insight into previously opaque aspects of the claims process – will be crucial to the evolution of the industry. Mr. Cupps will focus specifically on how to track and utilize previously unusable data in ways the industry has not seen before.

“As with any production process, the efficiency of the claims process solely depends on the knowledge of the best path to completion. In reality, that knowledge or visibility is not always clear,” said Michael Cupps, Senior Vice President, OC WorkiQ. “The only way to improve that process is to remove ‘Dark Events’. These are discrete actions that affect the state of claims, and normally go unrecorded by most claims processing and analysis systems.  Being armed with the ability to capture this data creates valuable and actionable analysis that can lead to greater efficiencies.”

The Analytics for Insurance Conference takes place May 11 – 12 at the Westin Prince Toronto. Mr. Cupps will give his presentation on May 11 from 2:50 p.m. – 3:10 p.m., and the subsequent panel discussion will take place from 3:30 p.m. – 4:00 p.m.