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.

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

 

Press Release — New Version of WorkiQ

OpenConnect Launches Upgraded WorkiQ Workforce Performance Measurement Software

Dallas, TX, January 21, 2015OpenConnect, a leader in business process intelligence and workforce analytics software and services, today announced WorkiQ 6.3, a new generation of the company’s successful workforce performance measurement solution. The new version of WorkiQ software provides even greater visibility into how employees perform their work, and a more detailed understanding of employee productivity rates.

WorkiQ is used by some of the country’s largest insurance providers, government agencies and financial services organizations to identify and codify the workplace traits of their high-performers, allowing all staff to benefit from these best practices; automate recurring tasks that have proven to be error prone; and improve employee engagement and accountability.

The new version of WorkiQ features the following enhancements:

  • Google Chrome Support – as many employers have implemented web-based applications, understanding work activity inside the browser is vital; WorkiQ 6.3 adds support for Google Chrome to the existing support for Microsoft Internet Explorer and Mozilla’s Firefox.
  • Advanced data capture – WorkiQ 6.3 is equally adept at gathering performance data whether an employee is in-house at work on a desktop, or is a remote/work-from-home employee logging in through a virtual network connection. Now with version 6.3, WorkiQ extends that data capture ability into the mainframe application environment, recording not just when and for how long an employee is logged-in to a mainframe, but which applications are being used most often and in what ways. Permitting a real-time view into the amount of work being completed.
  • Enhanced Process Tracking – WorkiQ 6.3 also now ships with advanced process tracking capabilities making it easier to re-use processes and sub-process models for fast and efficient configuration. This permits customers to measure multiple types of work, and categorization of the type of work being completed. While WorkiQ has supported the ability to track processes previously, this new enhancement will save administrators the time and money otherwise spent configuring new processes, putting useful data back into the hands of the back office managers.
  • User-friendly interface and next-generation reporting – WorkiQ 6.3 provides a simplified interface for both the IT administrator supporting the application as well as the user/manager benefiting from the application’s data. Advancements in reporting allow manager’s to receive a holistic view of their employees’ work activities across all platforms and applications they touch during the course of the workday.

“Keeping employees engaged and setting them up for success is more challenging than ever,” said Dr. Edward Peters, Chief Executive Officer, OpenConnect. “We’re working in digital environments and contending with the continued bombardment of interruptions throughout the workday. WorkiQ makes it possible to help employees understand and focus on the traits that generate success, improve production and reduce their company’s operating expenses.”

Pricing and Availability

WorkiQ 6.3 is available immediately. Pricing varies depending on specific customer configuration needs. For more information, please visit openconnect.com.

Request WorkiQ Demo

Media Contact

Greg Wise
Weber Shandwick, for OpenConnect
512-794-4716
gwise@webershandwick.com

Where Does the Time Go?

As another year turns the corner Father Time ticks on.   We look back on our 2014 activities and wonder…“where did the time go?”

Similarly on a daily basis I often look up from a busy day and realize it is almost time to shut down and often wonder… “Where did my day go?” The reality is very few people know how much time they spend on specific activities throughout the day.

Take for example, an Instant Message conversation.   A simple Skype IM comes in while you are working on an important presentation.   You immediately click to view the IM, respond, and change the entire focus of your mind.   While you may click back to the presentation, you just lost a few minutes and more importantly, it takes a little time to get re-focused.  What happens next – “bing” – they reply to your IM.   And the cycle continues.

This is not a rant on the evil ramifications of IM. I actually enjoy it as opposed to email, and it is part of our business culture. What matters however, is being able to track the available work time you have in a day and insure you are participating in the work that really makes a difference.

You may have read Josh’s recent post about the fitness tracker popularity.   Much like the trend of fitness trackers, we need to review where our teams spend their time. Using my own FitBit, I have awareness that I am extremely behind on my step goal today. While the tracking device doesn’t actually make me healthier, armed with this type of awareness in real-time I can endeavor to improve.  The same applies for back office teams.

WorkiQ will categorize work activity by application and process and begin to identify bottlenecks.   Armed with the data you can then coach employees in real-time on how to improve productivity and enhance overall work engagement.

Keep Father Time at bay and try WorkiQ as your ‘work Fitbit’. You’ve already identified goals for the New Year, let us help you identify how to reach them.

And welcome to 2015, wishing you all a great year!

Request WorkiQ Demo

Recorded Webinar — Improve Claims Processing Through Workforce Analytics

Webinar hosted by AHIP and WorkiQ recorded on December 9, 2014, featuring Molina Healthcare

Using technology to empower efficient claims processing

WorkiQ measures the activities of your back office team in real-time. With this data you can be proactive in re-capturing non-productive time and increase productivity in the process.

Molina Healthcare will discuss their experience using technology to support and improve claims operations. Areas such as process improvement, employee performance score carding and employee efficiency can all be directly impacted if the right technology is implemented.

Discussion topics include:

  • Electronic time motion study
  • Measuring claims examiners based on standards
  • Comparing claims examiners to their peers
  • Comparing time spent in productive activities that drive engagement

This webinar will explore emerging best practices using big data in capturing and measuring back office productivity. Armed with accurate and real time data, this webinar will also discuss a best practices approach to systematically improve back office operations through coaching, employee engagement strategies, and improving overall team productivity to breakthrough levels.

What you will learn by attending:

  • How providing visibility through real time collection, measurement and on-going monitoring can impact productivity in claims operations
  • Reporting and dashboard strategies to effectively improve employee engagement
  • The power of an engaged workforce with an active voice in the productivity measurement approach and interpretation

Click here to see the recorded webinar.

Smarter Work Through Workforce Analytics

As identified in our latest blog from Ed, “Achieving Rapid Payback on Real-Time Workforce Analytics…”, labor costs, overtime, contract workers and lost time due to ineffective measurements… are all challenges back office operations experience today. Now let’s take a few minutes to explore how your operation can get on the road to achieving that pay back in those significant loss areas.

There are 3 basic steps to a return on investment using workforce analytics.   Measure in real-time, Manage in real-time and Improve in real-time.   Let me explain further…

Current methods of self-reporting or attempting to gather information from multiple systems and consolidating to a single dashboard have proven either inefficient or inaccurate.   The only true method to payback is by instrumenting systems and processes that enable your People to have the data at their fingertips, providing the opportunity to “coach in real time”.   This approach has proven to provide real Results based on a Smarter Work approach.

Measure in real-time – By instrumenting your enterprise systems (desktops, virtual environments such as Citrix or the mainframe) your operation can begin collecting valuable big data on applications and websites being utilized; idle time, and time spent outside of productive applications. Without this real-time measurement, operations have little control over the timing of business agility or outcomes.  

Manage in real-time – Once this data is available to managers and directors decisions can be made in real-time about staffing, overtime and inventory distribution. These decisions can be made today vs. waiting for self-reporting or consolidated decisions that may be available tomorrow or later in the week.   These decisions can be based on facts in the moment regardless if staff is in the office, working from home, or even part of an outsourcing contract.

Improve in real-time – Now that decisions are being made on inventory and work. Overall team performance improvement begins to happen.   Recapturing lost time is finding new opportunities to improve individual performance, which rolls up to overall team improvement. Managers can now locate their true top performers to reward and recognize them, thus creating a culture of accountability and engagement.   Based on a Gallup Poll in 2013, “Companies with a highly engaged workforce outperformed other companies by 23%.”   Smarter Results!

WorkiQ is impacting back office operations in this manner today with immediate payback. It has been exciting to see the improvements our customers are attaining in months not years.

What is your WorkiQ?”

Request WorkiQ Demo