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Straight Through Processing One Year Later - ILTCI...
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Claims & Underwriting Straight Through Processing One Year Later
Transcript of Straight Through Processing One Year Later - ILTCI...
Claims & Underwriting
Straight Through Processing One Year Later
Straight Through Processing One Year Later
Panel Members:• Terese J. Capizzi, Director LTC Operations
Northwestern Mutual, Milwaukee, WI
• Kevin J Kelly Corporate VP and Chief Information Officer• Kevin J. Kelly, Corporate VP and Chief Information OfficerNew York Life’s LTC Division, Austin, TX
• Karen McMahon, Assistant Director LTC OperationsNorthwestern Mutual, Milwaukee, WI
• Pranav Patel, Director of IT Application DevelopmentLifeCare Assurance Company, Woodland Hills, CA
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Straight Through Processing One Year Later
Today’s Discussion
• What is Straight Through Processing (STP)?• What are some key enablers for STP?• Where can we use STP in LTC?• What opportunities can we leverage from other
product lines?• What are future enablers?
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Straight Through Processing One Year Later
What is Straight Through Processing (STP)?• STP is about…STP is about…
– Eliminating paper and manual tasks
– Automating from the front-end (app taking), through the back-office (underwriting, claims, payments reporting) without re-keying any datapayments, reporting) without re keying any data
– Reducing cycle times & improving unit costs
– Improving NIGO (Not In Good Order)
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Straight Through Processing One Year Later
Where can we use STP?
• New Business & Underwriting– Application submission– Requirements ordering– Underwriting decision
I iti l d l i t– Initial and renewal premium payments• Claims
– Assessments– Rules automation
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Straight Through Processing One Year Later
Enabling Technologies
• eForms• eSignature• Business Rules Engine (BRE)• Remote Deposit Capture• Imaging & Workflow
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STP Enablers
eForms (Electronic Forms)
• A system that enables forms to be completed electronically- Pre-fill with known data - Validate data real time- Obtain the correct form using reflexive questions
like TurboTaxA t t ti i kfl biliti- Automate routing using workflow capabilities
- Print desired documents
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eForms
Session 31 – Straight Thru Processing – One Year Later
eForms
eForms
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eForms
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eForms: Aggregation Tool
• Summary: Key Features- Customize application packet so only needed forms are included
d i t dand printed.- Cascade financial representative and insured name throughout the
application.- Enter information into all fields electronically, except signatures.- Save a partially or fully completed application- Secure email application to client to print, sign and return…or pp p , g
combine with eSignature capabilities
• Benefits- Professional application- Easier to read for application input- Can save and complete later
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Straight Through Processing One Year Later
Where else can we use eForms?
• New Business & Underwriting– Application submission– Policy changes during underwriting
C• Claims– Claim forms/kit
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STP Enablers
eSignature
• Any electronic sound, symbol or process to sign or authenticate a record
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eSignature
Meet with the client and fill out the Paramedical exam electronically for Life & DIParamedical exam electronically for Life & DI • More complete medical history• Eliminate incomplete exams• Eliminate incomplete exams• Results are available to the FR faster
Impacts• Typed medical historyTyped medical history • Complete doctor name and address information • eSignature by the Insured and the Examiner
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eSignature by the Insured and the Examiner
S feSignatureInsured eSignature added to the form
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Straight Through Processing One Year Later
Where else can we use eSignature?
• New Business & Underwriting– Paramedical examiner completing Medical
History QuestionnaireHistory Questionnaire – Application submission
Supporting forms– Supporting forms
Claims• Claims– Claim submission
Assessments
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– Assessments
STP Enablers
Business Rules Engine (BRE)
• Business rule– A statement of business logic that can be authored
d i t t d b t h i l b iand interpreted by non-technical business experts and invoked from an application for executionexecution
• Business Rule Engine (BRE)Business Rule Engine (BRE)– A system for creating, storing, and managing
business rules independently from an application
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Claim Adjudication Rule Generation Process
A l d th li Consolidated & created Analyzed the policy forms and extracted the business rules
the business rules per Company / Product / State
etc.,
~3000 forms ~450 Rules Benefits:
1 Eli i t d d t i li l ti t th1. Eliminated need to review policy rules every time to pay the claims
2 Eliminated manual calculation2. Eliminated manual calculation
3. Provided details of history at daily benefit level
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4. Gained efficiency, accuracy and audit trails
Straight Through Processing One Year Later
Where else can we use BRE?
• New Business & Underwriting– Automation of simple NB & U/W rule
• Claims– Intake process– Enforcement of payment or administrative rules, and
DOADOAs– Automation of state-specific business rules
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STP Enablers
Remote Deposit Capture
• A service which allows a user to scan checks and transmit the scanned images and / or ACH-data to a bank for posting and clearing
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Renewal Premiums Processing
Office Services
Change of Address
Checks
Billing Notice
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Straight Through Renewal Premium Processing
Images
A/R
Data Images
(*)
A/R
Data verification
Post Premium
Center
A/R verification payments
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Remote Deposit Capture
Benefits of Remote Deposit Capture:
• Minimize lost check by having an electronic record
• Quick access to the image of the check- immediate visibilityy
• Same day processing possibleSa e day p ocess g poss b e
• Create capacity by eliminating data entry
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Create capacity by eliminating data entry
Straight Through Processing One Year Later
Where else can we use Remote Deposit Capture?p
• New Business & UnderwritingI iti l d l i t– Initial and renewal premium payments
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STP Enablers
Imaging & Workflow• ImagingImaging
– Scanning paper documents into digital images– Storing data in a central information repositoryStoring data in a central information repository
• WorkflowWorkflow– Automatically deliver work to appropriate people
or automated step, based on business rules and prequirements.
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Imaging & Workflow
ProcessElectronic Transmission of the Application (ETA)
• Scan the application packet• Email to specified mailbox• Transmit the image through a file transfer• Upload and scanned automatically into the system and ready
for application inputfor application inputBenefits of ETA• Creates home office capacity
- no longer opening mail and imaging• Reduces overall cycle time
avoid ‘snail’ mail time
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- avoid snail mail time
Process Flow of Residency Letters
Outgoing Mail
Start
Outgoing Mail
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Process Flow of Residency Letters (cont.)
RLLetter
Incoming Residency Letter (RL) mail
IncomingMail
CommentCode for
Audit
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Technology Stack for STP
Requirement Ordering Services
eSignatureeForm
Remote Deposit Capture
Image Workflow
Business
Data
Rules Engine
Straight Through ProcessingStraight Through ProcessingStraight Through Processing Capabilities
Straight Through Processing Capabilities
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Requirements Ordering ServiceR i t O d i S iRequirements Ordering Service System (ROSS)
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ROSS
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ROSS
• Benefits– Ordering control– Cost effective– Real time processing and status
• Challenges– Finding the right vendor– Keeping up with ACORD standards
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Future STP Enablers
What are the next ‘Art of Possible ’ enabling technologies?
• eDelivery
• Customer Service Portals- eCorrespondenceeCorrespondence- Self service
• Mobility
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QuestionsQuestions++
AudienceAudience CommentsComments
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