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.

 

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.

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.

Workforce Analytics for the CFO

5 reasons CFOs are interested in workforce analytics & automation

  1. Identifying empty labor
    • 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.  WorkiQ provides real-time collection and reporting thus revealing instant performance measurement of both in-house and remote employees.   
  2. Identify areas for reduction of overtime
    • According to a recent survey, average Americans work an hour of overtime each week.  Sometimes the business may need overtime to get through peak periods but how do you truly know without accurate data?  WorkiQ provides real-time data showing if empty labor is a potential symptom for excess overtime.  The solution can identify the amount of time spent on productive and non-productive activities and categorize the type of work that consumes the most labor hours.
  3. 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, giving you true FTE analysis to insure you have the team for the workload.
  4. Real-time and accurate performance data
    • Identifying top performing teams and individuals is critical to building a culture of accountability and high employee engagement.  Real-time workforce analytics 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 make “in the moment” coaching and guidance for optimal performance.
  5. Spotting process deficiencies
    • Organizations can’t always see the different steps it takes to process a transaction within their operations.  By employing analytics to visualize the work path, you can identify the critical details needed to reduce bottlenecks.  Then these processes can be eliminated or automated through OpenConnect robotic process automation.

Analytics for Insurance Summit

OpenConnect CEO Dr. Edward Peters to Discuss the Potential of Technology and Data Capture at the Analytics for Insurance Conference

Dr. Peters will be featured in a session at the Analytics for Insurance Conference titled “Understand how analytics is changing claims handling and underwriting”

Dallas, TX, March 20, 2015 – OpenConnect, a leader in operational intelligence and workforce analytics software, today announced that CEO Dr. Edward M.L. Peters will be a featured speaker and panelist at the Analytics for Insurance Conference on March 25-26 in Chicago. Dr. Peters will focus on how technology and analytics can make claims handling more efficient and transparent.

The claims handling process involves massive amounts of data, but unfortunately much of this data has historically not been able to be tracked and measured in a meaningful way. Emerging technologies and the use of analytics that are capable of tracking this data can enable a new age of innovation and improvement in the claims handling process.

This session will look at a number of key areas in which automated processes and analysis can improve the claims process – in detecting fraud, reducing costs and creating real-time and actionable data. Dr. Peters will focus on how to identify and utilize previously un-captured data in ways the industry has not seen before. The ability to capture this data creates valuable and actionable analysis that can lead to greater efficiencies.

“In the claims process, only a small portion of the data are readily available for analysis, with a large portion going un-captured and therefore unavailable to analytical efforts,” said Dr. Edward Peters, Chief Executive Officer, OpenConnect. “‘Dark Events’ are discrete actions that affect the state of claims and normally go un-captured and un-recorded by most claims processing and analysis systems.  It is through the discovery, capture and analysis of ‘Dark Events’ that major improvements can be uncovered and realized.”

The Analytics for Insurance Conference takes place March 25-26 at the Hilton Chicago/Magnificent Mile Suites in Chicago, IL. Dr. Peters will speak on March 25th from 4:30pm – 6:00pm.

 

Media Contact

Tracy Donalson
Weber Shandwick, for OpenConnect
469-375-0236
tdonalson@webershandwick.com

Managers Dilemma: How Much Time Are Your Employees Productive?

Your associates are busy, but how much time do they spend in productive applications? Do you know what applications people utilize to get their work done? In this manager’s dilemma, I show you how to quickly customize a manager’s dashboard in WorkiQ Workforce Analytics to answer these questions, and point out the operational intelligence that all managers should know about how employees spend their time.

This dashboard displays:

  • The real-time percentage of work-hours spent in productive applications.
  • The amount of time each team member was idle, busy in “productive” applications, and busy in “non-productive” applications.
  • The amount of time each team member spent in specific applications or categories of work.
  • The amount of time each team member spent in social media, personal email, and other non-work activities.

Request WorkiQ Demo

 

Managers Dilemma: What Are Your Remote Employees Working on?

When are your telecommute associates online? When and how much time are remote employees engaged in a productive work process? You know your people are busy, but with the increasing popularity of work-from-home positions, it can be difficult to evenly measure in-house and remote workers. In this manager’s dilemma, I show you how to quickly customize a Manager’s Dashboard in WorkiQ Workforce Analytics to show which associates are online, and what they are working on, so location is no longer a concern.

This dashboard displays:

  • The online/offline status of each team member
  • The in-process/off-process status of each team member
  • The current processes each associate is working on
  • The current application each associate is in

I also show how to customize your Manager Dashboard.

Request WorkiQ Demo