Improve Insurance Operations with ECM

Transcription

1 Improve Insurance Operations with ECM DocFinity for Insurance: Enterprise Content Management and BPM/Workflow A publication from DocFinity

2 Contact DocFinity phone: web: Optical Image Technology, Inc. All rights reserved. DocFinity is a registered trademark of Optical Image Technology, Inc.

3 What to Expect with ECM Insurers have two competitive differentiators: price and quality of service. If you can keep operational costs down while improving responsiveness, you re ahead of the game. You can do both by using DocFinity to automate, standardize, simplify, and expedite the flow of information and task-completion across the enterprise. At the same time, you ll better control your businesscritical information, prevent redundancy and errors, and leverage the information stored in your other systems and software. DocFinity electronically captures, stores, indexes, retrieves, and manages text and non-text documents and files of all formats even images, voic s, and faxes making them accessible from any Web browser. So, underwriting applications, claims forms, risk assessments, financial information, supporting documentation, correspondence, and almost anything you might need or imagine can be accessed quickly and securely. DocFinity also enables: Electronic data capture at the time of application, enabling simple policies and claims to be processed in real time and more complex policies and claims to be pushed to senior underwriters and adjusters. Immediate access to payment history, other policy data, prior claims, risk assessment, and other information. The ability to add items such as damaged property photos, estimates, and inspection reports into the system from site locations in real time, enabling ready access and faster decisions. The ability to automatically generate custom letters or calls based on specific data as it enters the system. Advanced, intelligent search, enabling you to locate data within documents for expediting business processes or for e-discovery. Self-service options that improve service turnarounds and let skilled staff members spend more time at their core competencies and less time chasing information. Automation of archival, retention, and disposal schedules for records management and disaster recovery. Simple integration with legacy systems and/or underwriting, claims, policy administration, accounting, HR, and other applications. Monitoring and managing staff productivity, reassigning tasks, and balancing workloads. Security and audit trails to fulfill compliance requirements and demonstrate accountability. 3

4 Speed Doesn t Kill To provide quick and reliable service to your customers, agents, staff members, and other parties, and third-party vendors, information must be accessible now. The time spent searching for documentation, s, correspondence, and other materials constitutes lost time, money, and opportunity. DocFinity makes all vital information accessible in an instant, with the stroke of a key or the click of a mouse, enabling you to: Make information more accessible to all interested parties. Automate underwriting, policy, claims, or any other business processes. Reduce paper and lost information throughout your enterprise. Improve customer service and accelerate turnaround times. DocFinity enables employees to process more work in less time and to dedicate more time to serving policyholders. Workflow serves as the launching pad for automating business processes, pushing and pulling tasks according to your business rules and best practices, routing them to the right people at the right time for prompt action and auditable accountability, and ensuring people get fast service and reliable information the instant they request it. No more misplaced documents or lost productivity. No more prolonged audits. No more duplicate files. No more volumes of information that are difficult to manage and prioritize. Simply put, DocFinity serves as the conduit between people and people, people and systems, and systems and systems. It helps insurers work faster and smarter no matter what their size. People + Systems + + People + Systems 4

5 Over-Achieving Underwriters DocFinity can turn your underwriters into over-achievers by dramatically cutting processing times, while complying with regulations and SLAs. It enables underwriters to capture and access applications and supporting documents instantly. It standardizes underwriting procedures and ensures information is consistent and complete. It enables you to underwrite more business in less time, without increasing staff. It automates routine tasks, enabling faster decision-making. It flags exceptions for further review. And it improves internal and external communication. DocFinity helps your underwriting department: Automate tasks from the point of submission, enabling instant gathering of information to determine eligibility and ensure accurate rating. Expedite processing, reducing request and wait times for information. Expedite the discovery process. Issue policies quickly by pushing new policies through for immediate decisions. Monitor work volumes and employee productivity to prevent bottlenecks. Balance workloads based on volumes and completion rates. Expedite departmental approvals, denials, and signatures on documents. Integrate with policy underwriting and administration applications, leveraging the technology you already own. Improve profitability through workflow analytics and predictive modeling that enable continual improvement. Comply with regulatory requirements and manage retention schedules. To optimize your results, we ll help you with workflow design, business-process analysis, project planning, technology integration, and enterprise process engineering. DocFinity is everything you need to help your underwriters over-achieve. 5

6 Better Customer Service Providing better customer service is simple: streamline procedures. Optimizing your procedures for policy issuance, agency support, billing, claims processing, and other operations is easy with DocFinity. Processing that takes weeks to months on paper is reduced to days. And along with improving customer service, DocFinity helps increase customer retention, as well as revenues. Improve all of your policy servicing activities with: Electronic capture and management of documents, forms, s, faxes, and images. Updating of personal information by electronic transmissions, faxes, phone calls, and paper submissions. BPM/Workflow, which automates case assignment, tracks files, and electronically alerts agents and company personnel to cross-selling opportunities. The ability to automatically update third-party databases and/or applications with metadata entered on forms. The ability to create, index, manage, store, and route electronic forms, increasing efficiency and giving staff members and policyholders self-service access. Documents, forms, s, faxes, and images Users Automated and streamlined processes within DocFinity Update personal information Assign tasks, track files, alert agents Update applications and/or third-party databases Index, manage, store, and route 6

7 Your Claims to Fame It s often said that the measure of an insurance company is the manner in which it manages claims. DocFinity can improve your claims management by auto-populating claims processes with pertinent, accurate data from Web portals, PDAs, barcodes, and scanned images eliminating wait times for information. It can achieve straight-through processing, while giving policyholders, agents, adjusters, and other parties to claims access to pertinent information. It can collect, associate, and forward claims documents, s, voic s, faxes, photos, and other files for timely action. It can minimize costs associated with unsettled claims. It can monitor work volumes and employee productivity to prevent delayed decisions. It can expedite approvals, denials, and signatures on documents. And it can help you simplify audits and comply with regulations. And it can ensure rapid settlement, helping to avert increased damage costs from untreated problems such as mold or water damage. Property/Casualty Claims Adjudicating claims quickly, efficiently, and accurately leads to cost savings by all parties involved, as well as satisfied policyholders. DocFinity s ability to locate data quickly in disparate line-of-business applications and to put all the pieces together can save time and money otherwise lost to delays and/or continuing or worsening damage. DocFinity centralizes all claim-related information in a single repository, enabling ready, securely controlled access to all parties to claims. Online forms and barcode software simplify and standardize data capture to prevent redundancy and errors. Digital workflow pushes documents through to multiple channels securely and simultaneously, for review, approval, denial, and signatures. Decisions are made more quickly, keeping claim amounts from increasing unnecessarily, enabling insurers to expedite settlement, keeping claimants informed and happy. DocFinity helps claim processors: Standardize processes from FNOL through complete adjudication. Automate FNOL capture. Allow straight-through processing of first-pass claims. Automate distribution to internal and external adjusters. Allow access to pertinent documents and data securely, when and where needed. Provide business intelligence to management about any claim at any point in time. 7

8 Healthcare Claims The effective processing of healthcare claims requires four things: timeliness, accuracy, proper documentation, and the protection of privacy. DocFinity provides straightforward access to the proper information, as well as the power to get that information to the staff members or systems necessary to process it in a timely manner. The more claims you automate, the lower your costs and the higher your productivity, accuracy, and profitability. Quick evaluation of the medical necessity of services and supplies, reliable verification of benefits, and the identification of claims that exceed usual and customary guidelines all lead to faster settlement. DocFinity s automated workflow enables simultaneous review of materials and images, approval and signing of documents, and other actions that facilitate quick, sound decision making. DocFinity helps claim processors with: Digital storage that ensures easy search and immediate access to prior authorizations and other electronic images as well as correspondence, HCFAs, s, faxes, and a variety of other documents. BPM/Workflow that automates and standardizes processes so claims are processed consistently, accurately, and on time pushing tasks and files to predesignated persons for simultaneous review, annotations, signatures, approvals, and other actions, dramatically reducing turnaround times. Improved compliance with guidelines for record access, as well as clear, accessible audit trails. Users Voice files, s, faxes, images, X-rays, other documents DocFinity Workflow Process Review of all materials and images Evaluation / verification of need and benefit Clean Claims Approving & Signing all Documents 8 Exceptions Review

9 Adjustments for Adjusters Because DocFinity simplifies data gathering and analysis and because it facilitates quick and accurate decision making it allows you to validate claims, identify fraudulent claims, and deliver needed funds more quickly. When determining the extent of your company s liability on property, casualty, or personal loss or damages, adjusters constantly chase details and daunting volumes of data, from correspondence and interviews with medical specialists, agents, witnesses, and claimants to financial information and evidence to support contested claims in court. DocFinity accelerates claim approval by allowing you to: Access policies, claim histories, inspection reports, estimates, photos, and other documents over the Web, letting adjusters work remotely and at claims locations. Improve efficiency with online forms, enabling adjusters to provide instant information from site reviews to insurers and other parties. Make documents available for immediate review and implement self-service options for staff members and policyholders. Push documents and tasks for review, approval, denial, or signatures, dramatically accelerating turnaround times and settlements. Quickly address damages that otherwise might cost more over time, minimizing unnecessary payments and helping you make prompt payments to deserving claimants. Time Saver 9

10 Back to Front Improvement DocFinity improves the functioning of all organizational, back-office departments: Human Resources, Accounting, Legal, Accounts Payable, and more. Processes that involve action including multiple reviews, approvals, denials, and signatures benefit greatly from DocFinity s BPM capabilities, flowing tasks to the right people at the right time. DocFinity revolutionizes back-office processes, allowing you to: Leverage and integrate existing software investments. Create, capture, store, and manage personnel records and automate retention and disposal. Implement employee self-service, permitting staff members to submit sensitive information securely and confidentially. Centralize and secure data to comply with governance, security, and regulatory mandates. Monitor, measure, and balance workloads; prevent bottlenecks; improve productivity; and help you continually improve processes. Accounting and Finance If you re not automating your accounting processes, you re hemorrhaging money. Statistics show it can take more than $15 to manually process a single invoice. How much time do your staff members spend matching documents with requisitions, receipts, invoices, and other supporting documentation? How much money are you losing if you re unable to take advantage of early pay discounts from vendors? How much might you lose if you can t prove accountability? 10

11 Back to Front Improvement (cont d.) To minimize your exposure and maximize your efficiency, DocFinity will help you: Convert from paper to electronic processing, centralizing information in a secure repository. Eliminate costs associated with printing, mailing, and storage. Eliminate errors, lost documents, and missed deadlines. Automate A/R, A/P, and invoice processing. Establish best practices for processing invoices and receivables with consistency and accountability. Approve invoices and receivables electronically and process them immediately, requiring staff members to handle exceptions and discrepancies only. Expedite turnaround, eliminate errors, and reassign staff members. Get the status of accounts in the revenue cycle at all times. Leverage OCR to capture data in non-text documents to simplify processing, match invoices with receipts, or flow requisitions for approvals. Automate archival, retention, and disposal schedules in accordance with company, industry, and regulatory guidelines. Ensure disaster recovery and business continuity in the event of fire, flood, or other disaster. Implement governance procedures that ensure transparency, security, accountability, and auditability, showing who accessed what documents, and when. Human Resources Because every person is different, each applicant, employee, and retiree has unique documents and records often with differing deadlines for reviews, contract renewals, vacations, comp time, sick time, and more. DocFinity simplifies the corresponding processing challenges by providing: Integration with Lawson, SAP, PeopleSoft, and other HR applications, leveraging the value and extending the functionality of your existing investments. Electronic storage and retrieval of all records and personnel files credentialing, certifications, hiring, termination, policy documents, and others allowing you to manage information throughout the employment lifecycle. Employee self-service options that permit staff members to submit benefit and other sensitive information securely and confidentially. Workflows that push HR documents requiring approvals, signatures, or other actions to the right parties at the right time. Automation of routine procedures such as job postings and policy updates. Security and audit trails to adhere to governance and compliance initiatives. Reduced need for physical storage and its associated costs. 11

12 Back to Front Improvement (cont d.) Customer Service DocFinity elevates service levels by making relevant information instantly accessible. It enables quick, efficient access to current and historical documents that contain information on past requests, orders, and applications. It integrates with CRM applications to put customer information at the fingertips of your staff members. It ensures that inquiries are handled consistently and completely. It prioritizes time-sensitive inquiries automatically to comply with SLAs. It includes online forms to give customers and partners self-service options. It contains productivity and reporting tools that give you instant overviews of inquiries and your staff s ability to respond to them. And it enables automatic re-routing of inquiries in accordance with business rules and workloads, which results in better balance and faster service. Contract Management From collaboration and authoring through amendment, signature, and execution, DocFinity helps insurers manage contracts and negotiated agreements. DocFinity automates, standardizes, and electronically organizes terms, clauses, attachments, amendments, and other contract data as it moves through the organization. The single, secure repository for contracts, supporting documentation, and correspondence gives authorized users access to search, view, track, edit, and upload new files locally or remotely. It stores images, PDF files, Microsoft Word and Excel documents, voice files, pictures, s, faxes, and more. It automates processes, allowing you to flow contracts to the appropriate people at the appropriate time, in accordance with your procedures, policies, and best practices. And it provides real-time updates of contract status, with reports on pending contracts, compliance and audit trails, renewal dates, expiring contracts, and other data. In addition, DocFinity gives you: Notification when action is needed under the terms of each contract. Multi-level security. Advanced field and full-text searching. 12

13 How it Works From capture to COLD, from storage to retrieval, from BPM and workflow to archiving and disposal, DocFinity works to make your work easier. Since 1986, we ve been working to develop businessimproving software and services, improving business performance by providing better information management, enabling better decision-making, improving responsiveness and customer service, and reducing operational expenses. Here s how DocFinity works: Capture Our competitors charge extra for additional scanning stations and the volume of data scanned. We can t figure out why. So, we don t. Instead, we make it easy to get data, documents, and files of varying formats into the system quickly. Whether paper or electronic, DocFinity imports business and back-office documentation and information with a number of user-friendly tools: Scanning captures paper documents as they enter your organization. Indexing lets you categorize information the way you want to, retrieving it quickly and easily. Object Importer lets you import any type of file and save it to a batch for later indexing. Index Importer checks specified directories containing metadata and document pointers, automatically indexing documents into the repository. Importer lets you monitor accounts and import s and attachments. Print to DocFinity creates PDF versions of documents and saves them into the repository. COLD-ERM captures print streams for easy storage and retrieval of computer-generated reports. Access DocFinity s principal benefit is the ability to locate, retrieve, and put documents into your workflow immediately and securely, no matter where you are. That s why DocFinity gives you: A variety of search features that let you locate documents quickly by template, category, tree, and full text. Intelligent search that delivers a hit list of documents and files that meet search criteria. Results can be re-ordered and re-sorted on the fly. Thumbnails let you see images and other documents without opening them, and tabs allow you to click between hit lists. Four different views that let authorized users (customers, clients, partners, suppliers,and others) access files securely from a browser. Print Server that prints multiple stored documents without having to open them. Enterprise Search to enables full-text searches of information in your documents. 13

14 Architecture Because DocFinity is built on Java, J2EE, and Web Services, it can be a cross-platform, enterprise application, running on various operating systems and interfacing with various databases. Its architecture and technology constitute a powerful, flexible ECM and BPM suite that is reliable, easy to administer, and scalable to enterprise needs. It accommodates application server clustering, load balancing, and failover for performance and reliability. With one simple installation, administration and configuration are streamlined and occur in one central place. DocFinity supports two servers that use the J2EE standard: JBoss, the most widely used J2EE server, is bundled with DocFinity, creating one simple installation. Because DocFinity automatically installs and configures its own J2EE application server, you don t need J2EE expertise in-house. This makes DocFinity a wise and convenient choice for organizations with limited IT staff. And since JBoss is open source, DocFinity can keep costs lower for customers. WebSphere, the IBM application server, is included to support the many organizations already using it. With JBoss and WebSphere, DocFinity covers the most widely used application servers on the market, making it an efficient choice for many organizations. As administrators know, enterprise systems never retire; and DocFinity is built on a proven, industry-standard framework. It represents a wise, long-term investment in broadly used technologies that will be supported well into the future. 14

15 Integration After access, the biggest benefit of DocFinity is its ability to integrate with existing software applications, back-office systems, websites, portals, and other sources of business information. That lets you take advantage of even more of DocFinity s power by: Image enablement that puts information at people s fingertips by integrating DocFinity with line of business applications. Automating processes and tasks by integrating data from existing applications or sources. Offering clients, employees, and partners self-service options through webpage/portal integration. Extending auto-indexing to existing data sources to make retrieval even more efficient. Because DocFinity is open, flexible, and extensible, it enables integration on a number of different levels to ensure compatibility with your existing systems: DocFinity is written in SOAP-based Web services, which are published to our client base to leverage the APIs, simplifying integration, regardless of underlying protocols. Unlike ECM systems that use proprietary architecture, DocFinity s open standards give you the flexibility to enhance communication between systems. URL APIs enable integration with a simple URL call. Integration with Microsoft Office allows you to retrieve and upload documents from Microsoft Word. DocFinity Connect is a zero-programming integration tool that allows you to call documents from within DocFinity with a single keystroke and to integrate DocFinity with your line of business applications. Fax Integration allows you to integrate DocFinity with electronic fax servers. 15

16 Automation DocFinity s BPM capabilities make it easy to use and configure workflows. Browser-based, all of its features from process modeling and design to activity and task processing are intuitive, easy to use, and proven to be effective. With BPM and workflows that push information throughout the organization for faster turnaround and greater efficiency, DocFinity will help you: Eliminate the need to pass documents manually. Streamline electronic routing to reduce cycle times, paper flow, and manual processing. Increase productivity, efficiency, and accuracy by assigning rules to automatically drive the required actions, in their proper order, to the responsible individuals or group. Expedite and prioritize business to enable group routing, distribute tasks, and prevent bottlenecks. Comply with company and industry regulations for privacy and standardization, ensuring compliance and accountability. System Administration DocFinity streamlines system administration with a simple, intuitive, web interface for all configuration and management activities. This allows administrators to: Handle complete system administration from any location. Manage the entire system from a single interface. Minimize the time and effort devoted to administration. Lower your system TCO. 16

17 Lifecycle Management Due to company, industry, governmental and other regulatory guidelines, you may be required to retain records for years sometimes decades beyond the point at which they re accessed regularly. To comply with those same guidelines, you may be required to dispose of records and other documents after prescribed retention periods. Failure to comply can expose your organization to fines and other penalties. Along with retention and disposal, long-term storage and disaster recovery are equally critical considerations. And, at any time, you may be required to produce documents on demand by an auditor, an attorney, a customer, or an interested party. DocFinity automates your records retention/disposal schedules, backing up all of your vital information all without human intervention after the initial set-up. It lets you manage your records throughout every stage of the document lifecycle, providing: Archiving and long-term storage. When records are no longer accessed regularly but have to be retained, archived long-term to comply with regulations, and accessed on request DocFinity lets you migrate them to inexpensive storage. This saves money and ensures retrieval is immediate. Disaster recovery. Configure DocFinity to copy documents to off-site storage or to multiple servers at multiple sites. You also can configure it to perform backups whenever you specify, removing the potential for human error, as well as risks associated with floods, fires, tornados and other disasters. Retention. By allowing you to automate document retention schedules,docfinity ensures that records are available when needed and are not destroyed prematurely. Disposal. DocFinity automates records disposal, ensuring that documents are not held beyond their mandated retention periods. 17

18 Purchasing Options After more than 25 years, we understand no two companies are alike. So, we build options into our software and our pricing. We go the extra mile to meet your circumstances and your needs. And we offer the best price-to-feature ratio on the market. That s just how we do things. 1. Traditional licensing, which includes: A one-time upfront fee. Complete ownership and access, 24/7. A strong system that is implemented easily and affordably. 2. Subscription pricing, which includes: No capital expenditure. Ownership of your data and files. A monthly and in cases tax deductible operating expense. 3. Hosting option, which includes: Enabling owners of a perpetual license to host their DocFinity Software Stack (and other applications) in our secure data center (providing HIPAA, DOD, CMS, and SAS-70 class security and availability). Access 24/7, 365 with varying service level options. A monthly operating expense. 4. DocFinity Live Software as a Service (SaaS), which includes: The complete DocFinity Suite. Secure access to your data with 24/7, 365 uptime. A monthly operating expense pay-as-you-use model. 18

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20 It s Business Improvement Insurance You might be able to reduce your operational costs, increase your efficiency and productivity, and improve your responsiveness without DocFinity but not as much, not as well, and not as quickly. Given the risk and the opportunity cost, why would you try? DocFinity has been automating, standardizing, simplifying, and expediting the flow of information and task-completion for insurers since That s a record as long as it is successful. If you re ready to better control your business-critical information, prevent redundancy and errors, and leverage the information stored in your other systems and software, ask us how successful. We ll be happy to tell you and to show you how successful you can be, too. Contact Us Today phone: \ fax: \ info@docfinity.com \ web: optical image technology, inc.