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.

Measure Twice – Cut Once

For a carpenter, hasty cuts can result in an expensive loss of time and materials. Hence, the phrase “measure twice; cut once”. Applying this “measure twice & cut once” principle to back-office operations simply means; you can’t improve what you don’t measure.

[Whitepaper] IDC Analyst Connection: What Gets Measured Gets Better: Improving Performance

“WorkiQ is helping us have effective conversations with employee’s we were previously unable to have.” – Manager of Business Intelligence, Top Blue Cross & Blue Shield Plan

Many employees, especially those who choose back-office careers, are unable to communicate their challenges to managers or peers. One of the largest health plans in the country recently provided a great example.

A claims examiner, who we will call “Mary”, was consistently missing production numbers. The health plan’s claims system could report the number of claims Mary worked, and her average time-per-claim, but it could not explain “why” she was below team standards. After several warnings, Mary was on the verge of disciplinary action. With a WorkiQ pilot about to start, her management decided to wait until they could analyze her daily activity.

It turns out that Mary was not taking breaks, and her lunch was rarely more than 10 minutes. She spent more time in “productive” applications than anyone on her team, but this effort was not reflected in the output of her work.

Mary’s WorkiQ dashboard revealed that she was spending her breaks doing research through company documents and online resources. As a result of real-time data, it was easy to determine she did not have the training to perform at expectations. Working with her manger, Mary was able to join the proper training programs, and she was partnered to a mentor. Employee turnover is a huge expense in money, time and resources, WorkiQ is providing valuable empirical data to help Insurance companies successfully evaluation workforce performance based on facts.

By adding a layer of operational visibility through desktop analytics, Mary is now one of her department’s top performers. In the future, Mary can use a peer-comparison dashboard to see if other top performers have found more efficient ways to process claims.

WorkiQ Peer Performance Comparison
Peer Performance Comparison Dashboard – WorkiQ Desktop Analytics

Stories like this are fairly common, and a similar case occurred here at OpenConnect with one of our developers. To learn more about how desktop analytics can help your operations department, continue reading The positive impact of “Big Brother” software.

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.

 

We’ve Come a Long Way

Recently my colleagues and I were discussing the ‘old days’.  Several memories came back to us.  They included having only 2–3 channels on the TV, and for some of us old enough to remember color vs. black & white screens.  At the time there was no remote control, progressing to today where we have too many on the coffee table.  Now we have access to any show, any time, streaming anywhere we want.

Banking was more difficult than today.  Back then the only way to conduct business was with a human at a branch.   Then came the ATM which revolutionized self service.   Now we have on-line capabilities to pay on demand and schedule payments on a recurring basis, eliminating the requirement to involve human activities.

Letters turned to faxes, faxes turned to emails, emails are now being taken over by texts, Skype and other IM software.

We’ve come along way since those days, and technology continues to improve our lives.  The same can be done for automating your operations.  The back office of Health Plans has volumes of repetitive work to be completed in Claims and Enrollment.   In most cases today, this work is all manual.   With the increasing volume due to ACA many plans are being forced to pay significant overtime or outsource more work.  Due to this demand new people make mistakes and those easy tasks turn into more rework events.  It is time to evolve in the back office much like the TV and banking.

Robotic Process Automation (RPA) has improved the first pass rates of insurance companies in astounding numbers.  One customer saw their auto adjudication increased from 77% to 92.4% in just a few years.  They are saving millions annually by controlling labor costs.   Because robots work 24 hours they are processing more claims per day.  Large or small firms producing repetitive work can benefit from RPA by augmenting with Robots.  Imagine what that could mean in your organization.

When you think about all that technology has done for us in our personal lives, why not improve our corporate lives too?  It’s worth looking into automation, analysis and overall improvement of your organization.

OpenConnect automation

 

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.

ROI From Real-Time Desktop Analytics

Identifying top performing teams and individuals is critical to building a culture of accountability and high employee engagement. Real-time desktop analytics provides the operational intelligence necessary to evaluate true staffing needs, reduce outsourcing, and lower the overall costs of operations. By providing dashboards with insights into the actual performance your managers will be empowered to make “in the moment” coaching and guidance for optimal performance.

Using your own data learn how your operations will save. Try our new online Savings Calculator.

Three areas you can find savings.

Productive Hours

On average US employees waste 2 hours a day beyond breaks and lunch hour. If your organization can re-capture part or all of this “empty labor” productivity will increase and your organization can do more work with the same staff. WorkiQ provides real-time data showing the amount of time spent on productive and non-productive activities and categorizing the type of work that consumes the most labor hours.

Reducing overtime

According to a recent survey, Americans work an average of one hour of overtime each week. Sometimes your business may need overtime to get through peak periods but how do you truly know without accurate data? WorkiQ provides real-time data showing where you may need more, or less, of the work being done.

Eliminating self-reporting

Many companies only have self-reporting methods or use disparate data from multiple core systems to track the amount of work and time spent on various tasks. These self-reporting methods rob your employees of time that could be spent doing real work.

Try our ROI tool and let us know what you think.

WorkiQ Savings Calculator

Analytics and Automation for the Back Office

5 reasons Back Office Operations are interested in workforce analytics & automation

  1. Measure in Real-Time
    On average US employees waste 2 hours a day beyond breaks and lunch hour. Real-time workforce analytics will capture activity in real-time of all associates, even those at-home, to identify productive and unproductive practices. WorkiQ captures all counts, time, and outcomes of activity so work can be categorized and managed.
  2. Manage in Real-Time
    Employees perform at varying levels of productivity and efficiency based on training, engagement, experience, and even acute situations in their personal life. Effective managers need reliable operational intelligence to identify if workers need training or if they are not optimizing work hours. WorkiQ provides the operational intelligence needed to identify, improve, and reward employ­ees through real-time management dashboards.
  3. Improve in Real-Time
    Dramatic productivity improvements start with increased engagement. Through awareness, scorecards and gamification; WorkiQ work­force analytics delivers a wide range of reports that empower people at every level of the company to compete and engage. Through real-time metrics, as opposed to infrequent performance reviews, associates know how they are performing in com­parison to their peers, where they excel, and where they can improve. Managers can compare employees with accurate stan­dards, reward superstar performers, and see where their team ranks against other groups or departments.
  4. Optimizing labor costs
    Companies using data-driven decision-making were, on average, 5% more productive and 6% more profitable than their competitors. Back office operations largest cost is labor. By using WorkiQ, you are able to identify empty labor and recapture productive hours, identify the true need for overtime costs, and utilize real-time data to measure the ability to work the inventory.
  5. Robotic Process Automation
    A natural utilization of operational intelligence is identifying opportunities for robotic process automation (RPA). Identifying and replacing routine or repetitive back office work with software robots enables companies to save considerable expense. Insurance companies, for example, use robots for their claims / auto-adjudication improvement. With a complete solution to identify, configure and execute, OpenConnect automation provides a complete solution providing significant savings back to your company.

Desktop Analytics for HR

5 reasons HR is interested in desktop analytics

  1. Accurate and real-time performance measurement
    Identifying top performing teams and individuals is critical to building a culture of accountability and high employee engagement. WorkiQ provides the operational intelligence necessary to evaluate true staffing needs, reduce outsourcing, and lower the overall costs of operations. By providing real-time dashboards with insights into the actual performance at any given moment your managers will be empowered to provide guidance for optimal performance.
  2. Increase employee engagement
    Companies with “Highly Engaged” employees outperform other companies by 23%. Identifying areas based on true performance measurement to reward top employees is difficult for most companies. Real-time workforce analytics provides the ability to see in real-time top performers. With this info companies can introduce gamification, leader boards, and rewards systems to encourage new levels of engagement.
  3. Identifying hidden potential
    Analytics can be used to identify high-performing teams and individual team members. Analyzing patterns of successful work results enables companies to spot individuals who outperform their peers, utilize their time efficiently, and analyze the best use of business applications to complete the job at hand.
  4. Identify coaching opportunities
    On average US employees waste 2 hours a day beyond breaks and lunch hour. However, most companies only have self-reporting methods to track the amount of work and time spent on various tasks. Real-time collection and reporting reveals instant performance measurement of both in-house and remote employees it allows for “in the moment coaching” opportunities and significantly recaptures empty labor hours.
  5. Sourcing Big Data for workforce analysis
    Do you have the right amount of people assigned to the appropriate inventory of work? How many people do you need to handle open enrollment this year? Take the guessing out of staffing; WorkiQ provides data on actual activity and work productivity providing true FTE analysis insuring your company has the right size team for the workload.