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Accelerating Claims Automation
©2016 Zia Consulting, Inc.
The Reality of Claims Processing
Where You Spent Money Where You Spend Money
©2016 Zia Consulting, Inc.
Costly Error-
ProneSlowComple
x
People, Paper, Process
©2016 Zia Consulting, Inc.
Impact of Claims Automation
©2016 Zia Consulting, Inc.
What’s In It for You?
 Profitability
 Customer Satisfaction/Retention
 Compliance
 Growth
 Actionable BI
©2016 Zia Consulting, Inc.
What If We Classified Automatically?
Your Classification Our Classification
©2016 Zia Consulting, Inc.
And If Processes Were Automated?
Your Process Our Process
©2015 Zia Consulting, Inc. All Rights Reserved.
©2016 Zia Consulting, Inc.
What If You Kept the Same Tools?
Your Users Our Users
©2015 Zia Consulting, Inc. All Rights Reserved.
©2016 Zia Consulting, Inc.
Zia Claims Automation
 Content Hub
 Any Source: Paper, Email, Upload, Text, EDI
 Any Type: Documents, Video, Audio
 Advanced Routing
 Intelligent Capture
 Mailroom, In-Process, Mobile
 Even Handwritten Forms
©2016 Zia Consulting, Inc.
Tailored for Your Business
 Automated Records Management
 INTEGRATION
 Claims Management System – Guidewire, Duck
Creek, Custom/Legacy
 Email
 Other Business Systems
Activiti BPM
2010
Introducing Alfresco
©2016 Zia Consulting, Inc.
Introducing Ephesoft
 Today’s Alternative to Costly/Complex IDC
 Business Selected + IT Approved
 Automated Classification & Extraction
 Mailroom Automation Solutions
 Embedded Capture
 Extended (Mobile) Capture
©2016 Zia Consulting, Inc.
Case Study: Claims Automation
 The Problem:
 Slow, Manual Paper-Based Mailroom
 Multiple Core Systems and Legacy ECM Repository
 Limited Ability to Access Claims Content Based on Roles
 The Solution:
 Ephesoft Intelligent Classification & Extraction
 Alfresco Content Hub with Intelligent Routing
 “Virtual Repository” for Access to Legacy/Core Systems
©2015 Zia Consulting, Inc. All Rights Reserved.
©2016 Zia Consulting, Inc.
Case Study: Additional Tools
©2015 Zia Consulting, Inc. All Rights Reserved.
©2016 Zia Consulting, Inc.
Case Study: The Results
 Transforming the Business:
 Initial Processing Reduced from Eight Hours to 15
Minutes
 Single “System of Record” with Access Via User Tools
 Zia ActiveMigrate to Move Over 10 Million Legacy
Documents in Seven Days
©2015 Zia Consulting, Inc. All Rights Reserved.
Accelerating Insurance Claims Automation
Who is Zia?
EST.
2003
Boulder, CO
Critic
al
Not
Casual
Controlling Chaos
+
Delivering Rapid ROI
Process &
Integratio
n
Open
Platforms
Content People
©2016 Zia Consulting, Inc.
Zia Insurance Solutions
 P&C, Life, Reinsurance, Specialty
 Automation: Claims, Applications
 Back Office: Contracts, AP, HR
 Office 365/SharePoint, SAP, MS
Dynamics
 Migration/Modernization
 Cloud Services
©2016 Zia Consulting, Inc.
Zia Cloud Services
 Cloud Installation & Integration
 Cloud Migration Services
 Zia Managed Cloud
 Digital Asset Storage
 Photos/Videos/Audio
 Insurance Claims
©2016 Zia Consulting, Inc.
Next Steps
 Claims Automation Demo
 Claims Automation Assessment
 Managed Alfresco/Ephesoft Trial
 Zia Insurance Automation Solutions:
ziaconsulting.com/insurance-solutions
©2016 Zia Consulting, Inc.
Next Steps
©2016 Zia Consulting, Inc.
Automation Whitepaper
 Available Now to All Webinar
Attendees
 Solution Details
 Partner Technologies
 Case Studies
5 5 2 5 C e n t r a l A v e . # 2 0 0 8 8 8 . 7 3 2 . 4 1 0 1
B o u l d e r , C O 8 0 3 0 1 z i a c o n s u l t i n g . c o m
For those in the insurance industry looking to optimize their claims processes, our white paper will
guide you through a solution accelerator model that can be applied to your business. See how our
work with best-in-class technology platforms—integrated with core claims systems you already have
in place and existing business processes—can rapidly deliver cost savings and enhanced customer
satisfaction. Case studies throughout the paper will show examples of how these claims automation
solutions work to bring efficiency to organizations across the industry.
Accelerating the Claims Process:
Reduce Costs and Enhance Customer Satisfaction
Questions?
Phil Robinson
SVP Business Development
Zia Consulting
phil@ziaconsulting.com

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Accelerating Insurance Claims Automation

  • 2. ©2016 Zia Consulting, Inc. The Reality of Claims Processing Where You Spent Money Where You Spend Money
  • 3. ©2016 Zia Consulting, Inc. Costly Error- ProneSlowComple x People, Paper, Process
  • 4. ©2016 Zia Consulting, Inc. Impact of Claims Automation
  • 5. ©2016 Zia Consulting, Inc. What’s In It for You?  Profitability  Customer Satisfaction/Retention  Compliance  Growth  Actionable BI
  • 6. ©2016 Zia Consulting, Inc. What If We Classified Automatically? Your Classification Our Classification
  • 7. ©2016 Zia Consulting, Inc. And If Processes Were Automated? Your Process Our Process ©2015 Zia Consulting, Inc. All Rights Reserved.
  • 8. ©2016 Zia Consulting, Inc. What If You Kept the Same Tools? Your Users Our Users ©2015 Zia Consulting, Inc. All Rights Reserved.
  • 9. ©2016 Zia Consulting, Inc. Zia Claims Automation  Content Hub  Any Source: Paper, Email, Upload, Text, EDI  Any Type: Documents, Video, Audio  Advanced Routing  Intelligent Capture  Mailroom, In-Process, Mobile  Even Handwritten Forms
  • 10. ©2016 Zia Consulting, Inc. Tailored for Your Business  Automated Records Management  INTEGRATION  Claims Management System – Guidewire, Duck Creek, Custom/Legacy  Email  Other Business Systems
  • 12. ©2016 Zia Consulting, Inc. Introducing Ephesoft  Today’s Alternative to Costly/Complex IDC  Business Selected + IT Approved  Automated Classification & Extraction  Mailroom Automation Solutions  Embedded Capture  Extended (Mobile) Capture
  • 13. ©2016 Zia Consulting, Inc. Case Study: Claims Automation  The Problem:  Slow, Manual Paper-Based Mailroom  Multiple Core Systems and Legacy ECM Repository  Limited Ability to Access Claims Content Based on Roles  The Solution:  Ephesoft Intelligent Classification & Extraction  Alfresco Content Hub with Intelligent Routing  “Virtual Repository” for Access to Legacy/Core Systems ©2015 Zia Consulting, Inc. All Rights Reserved.
  • 14. ©2016 Zia Consulting, Inc. Case Study: Additional Tools ©2015 Zia Consulting, Inc. All Rights Reserved.
  • 15. ©2016 Zia Consulting, Inc. Case Study: The Results  Transforming the Business:  Initial Processing Reduced from Eight Hours to 15 Minutes  Single “System of Record” with Access Via User Tools  Zia ActiveMigrate to Move Over 10 Million Legacy Documents in Seven Days ©2015 Zia Consulting, Inc. All Rights Reserved.
  • 17. Who is Zia? EST. 2003 Boulder, CO Critic al Not Casual Controlling Chaos + Delivering Rapid ROI Process & Integratio n Open Platforms Content People
  • 18. ©2016 Zia Consulting, Inc. Zia Insurance Solutions  P&C, Life, Reinsurance, Specialty  Automation: Claims, Applications  Back Office: Contracts, AP, HR  Office 365/SharePoint, SAP, MS Dynamics  Migration/Modernization  Cloud Services
  • 19. ©2016 Zia Consulting, Inc. Zia Cloud Services  Cloud Installation & Integration  Cloud Migration Services  Zia Managed Cloud  Digital Asset Storage  Photos/Videos/Audio  Insurance Claims
  • 20. ©2016 Zia Consulting, Inc. Next Steps  Claims Automation Demo  Claims Automation Assessment  Managed Alfresco/Ephesoft Trial  Zia Insurance Automation Solutions: ziaconsulting.com/insurance-solutions
  • 21. ©2016 Zia Consulting, Inc. Next Steps
  • 22. ©2016 Zia Consulting, Inc. Automation Whitepaper  Available Now to All Webinar Attendees  Solution Details  Partner Technologies  Case Studies 5 5 2 5 C e n t r a l A v e . # 2 0 0 8 8 8 . 7 3 2 . 4 1 0 1 B o u l d e r , C O 8 0 3 0 1 z i a c o n s u l t i n g . c o m For those in the insurance industry looking to optimize their claims processes, our white paper will guide you through a solution accelerator model that can be applied to your business. See how our work with best-in-class technology platforms—integrated with core claims systems you already have in place and existing business processes—can rapidly deliver cost savings and enhanced customer satisfaction. Case studies throughout the paper will show examples of how these claims automation solutions work to bring efficiency to organizations across the industry. Accelerating the Claims Process: Reduce Costs and Enhance Customer Satisfaction
  • 23. Questions? Phil Robinson SVP Business Development Zia Consulting phil@ziaconsulting.com

Notas del editor

  1. Welcome – thank you – as emily mentioned – three part series focused on how automation solutions built w/ modern technologies can save you time & money, enhance customer satisfaction & retention, and even address data security what do I mean by this title Blog – commercials during football games, etc… – allstate, farmers, liberty mutual, etc… iphone app – take a picture, get paid What about everyone else – literally thousands of insurance companies across country and around the world – like Baldwin & Lyons insurance, case study discussing today – who provides specialty insurance to the transportation industry – how can you benefit – and BTW – some of those companies I’ve named, also benefit Phil Robinson – bit of my background – before moving into technology and ECM specifically, spent 10+ years in insurance, both P&C and Reinsurance But not about me, the processes and systems that I’ve used - About your organization – your systems, your processes   Today’s focus on Claims Automation – not about replacing your Claims Management system – you have one, you’ve likely invested significant amounts of money into it – whether Guidewire, others   About automating the business processes you use – I’ll be Introducing a number of tools / technologies that play a key role in building a solution – but again is about finding the exact right fit for your organization, although will talk about how worked for Baldwin & Lyons   Our IP as Zia – understanding how to apply modern, really next-generation technologies to your business process – in this case claims – how to apply intelligent capture, email integration, central content hub for document & image/video management, claims system integration, records management, and more…
  2. Insurance is different – little differentiation in “products” – so really focus on price and service Obviously is a promise to pay – and this is the “moment of truth” in industry terms – oh and typically over 50% of claimants are not fully satisfied – which means they switch… And have micro regulation – state specific regulation (much less country specific) And regulators – more highly focused on claims – since over half of complaints related to that area So what do we mean here – Invested in modernizing core systems / insurance suites – your Claims Management System – guidewire, duck creek, whomever In many cases – ignored the Claims Process – how claims received, how manage paper, workflow, access to documents, storing of records, EXACTLY THE CASE WITH ONE OF OUR CUSTOMERS – A homeowners insurer in a catastrophe-prone area, after deployment of a new Claims Management System (one of those mentioned) – actually found that many of the costs actually came prior to interaction with claims system – together with IT team, deployed a new Intelligent Capture technology with remote scanning and email integration, using a technology called Ephesoft who we’ll discuss today, and also a new content hub, Alfresco who we’ll discuss today, and integrated w/ claims management system
  3. Costly – Infosys estimate – 7.5% of total operating costs just on claims processing! (not claims) – large cost center Complex – Claims documents via paper, fax, email, upload, mobile – what about facebook or twitter? Move from polaroid pictures when I started in insurance – to now videos taken on mobile phones – how manage, how store Oh – and because of M&A – B&L had 6 different claims systems! For many – because of the lack of integration – for digital documents, perhaps arriving via email – have Print + ReScan issue Slow – Modern consumer – want instant access, instant answers – where’s my claim status All of the issues discussed from paper, people, process lead to delays Error Prone
  4. most estimates are minimum 50% reduction in costs – at Zia talk about ROI less than 9 months, 50%+ increase in productivity Customer Satisfaction / Retention – about better service: Most estimats 85% reduction in time to process with automation B&L – discuss throughout – 8 hours down to 15 mins Declined brand loyalty Focus on customer service as a differentiator – customer retention is really a huge issue – don’t discount the value of simply being able to answer a question about a claim – where in the process, what received / missing, etc… Compliance – Again regulatory agencies increasingly focused on claims as area of concern Growth – Major concerns with B&L limited from growing by ability to process docs – claims specifically example case study, grow 10-20% annually without any hiring Also - benefit of flexibility in business process – new lines of business, new territories (states/countries), etc… Actionable BI –
  5. Everything – whether paper, fax, email, upload, mobile, etc… Classified, data extracted & validated With full page OCR – and without bar codes or seperator pages With accuracy
  6. And kicked off business process Flexible Tasks / roles, integrated with tools like Outlook, a content / ECM hub – and of course your Claims Systems Automation of tasks like Records Management
  7. And ultimately the value of letting people use the tools they know, and work with every day – from outlook to claims system – enhances productivity and adoption of systems and processes Not “two screen” problem Not “print & rescan” problem Single system of record, with access for all
  8. Mature, proven technology – both Alfresco ECM in 2005 and Activiti BPM from 2010 As see – now over 200 customers, with over 7 billion docs stored in Alfresco Open source – but more important to us is open platform Tagline is Simple, Smart, Secure – Alfresco combines the smarts IT needs with the simplicity users love and the security business can count on. Simple - Work Any Way, Anywhere Content access from familiar apps and devices Seamless integration with the apps people “live in,” like Microsoft Outlook, Microsoft Office, Google Docs, and Salesforce Mobile access from tablets and smartphones Access via friendly web-based UI or desktop file system Smart – look at Activiti - Automated workflow— Replaced complex, manual process with simple, flexible, task-based workflows Integrated with email for notices/reminders and is auditable across all steps Advanced, actionable analytics to drive business process improvements Introducing Alfresco Activiti BPM - Alfresco Activiti provides a highly scalable, Java-based, BPMN2.0 workflow and BPM application targeted at business users, developers, and administrators. Designed to simplify the workflow process while still delivering enterprise-class BPM, Activiti delivers intuitive task management, with mobile access, and simple process execution. Security – both data security – which we’ll cover in 3rd webinar – but also features like Records Management Robust capabilities built for ease of use DOD 5015.02 certified records management Automated, rules-based lifecycle management Full audit trail for compliance reporting Single solution to manage records and other content Where work in insurance – some of the biggest names obviously – and many others not listed here
  9. As mentioned – alternative to legacy vendors like Kofax & Captiva What’s Different – Business Selected Subscription or Purchase pricing Eliminate click or page charges Lower overall solution price IT Approved Thin client architecture Use of open standards Simple to Install, Train System, Train Users Match / exceed capabilities of legacy systems Intelligent Mailroom Automation Input: scanned documents, email attachments, faxes, uploaded documents Classify: identify document types in the file WITHOUT bar codes/separator pages Extract: data from structured/unstructured documents Deliver: to ERP, CRM, ECM Zia’s “In-Process Capture” (IPC) Utilizing Ephesoft Web Services Embedded into: ECM (Alfresco) SharePoint Portal / Website / ERP / CRM Delivered within workflow / business process Accelerate Mobile Capture Based on Ephesoft Mobile SDK Mobile Classification & Extraction Mobile IDC Administration Constituents to Field Reps Save Time, Save Money Lexmark – “accurately extracts critical information from hard copy documents without having to rely on barcodes, templates or keywords. The solution validates the extracted data and passes it to claims processing systems or other applications” Reduce costs, improve customer service, decrease errors
  10. So let’s see what this looks like for one of our customers – as noted -  Baldwin & Lyons specializes in insurance for the transportation industry. Through its many property and casualty insurance companies and brokerage firms, the company accepts risks covering more than a dozen different specialty products and services. After years of growth recognized need to address number of issues: Very paper based, manual – recognized need for new solution for digital imaging including classification & extraction Content silos – had created mainframe based solutions over years, resulting in six different policy admin systems, billing systems, and claims system Access – legal team to access claims documents, had to actually ask someone in claims – wanted a single system of record that all could access who needed Baldwin & Lyons Insurance Solution Ephesoft for Intelligent Classification & Extraction Established Alfresco as an “ECM Content Hub” & Activiti BPM “Virtual Repository UI” for access to Legacy / Core Systems
  11. So let’s see what this looks like for one of our customers – as noted -  Baldwin & Lyons specializes in insurance for the transportation industry. Through its many property and casualty insurance companies and brokerage firms, the company accepts risks covering more than a dozen different specialty products and services. After years of growth recognized need to address number of issues: Very paper based, manual – recognized need for new solution for digital imaging including classification & extraction Content silos – had created mainframe based solutions over years, resulting in six different policy admin systems, billing systems, and claims system Access – legal team to access claims documents, had to actually ask someone in claims – wanted a single system of record that all could access who needed Baldwin & Lyons Insurance Solution Ephesoft for Intelligent Classification & Extraction Established Alfresco as an “ECM Content Hub” & Activiti BPM “Virtual Repository UI” for access to Legacy / Core Systems
  12. Was average of 7-8 hours (say 8 hours) from time documents arrived until a claims adjuster could work on them, now down to 15-20 minutes (say 15 minutes) "Revolutionize" the business - didn't change, transform Single system of record - previously if legal wanted to see claims docs, had to request access to claims management system - now access direct, original docs in Alfresco - as does claims through CMS Zia’s ActiveMigrate to move 10 Million Documents from Legacy Systems Roadmap for SharePoint and Email Integration   “We thought pulling off a cultural change was going to be a challenge, but it turns out, once you get people engaged and excited about something, they trigger the change and you don’t have to drag them along. Today, change is a way of life for people we didn’t think it would be easy to convince to change at all” – Brian Gray, Managing Director of Application Development, Baldwin & Lyons
  13. Look at a really simple demo of auto claims process – starts with… Individual has just been in a accident, where other party at fault – and so contacting that parties insurance company Called into them – and advised need to provide drivers license, proof of insurance card – and photos of accident Show process where email created and sent to individual, and how documents and workflow managed from there Using Ephesoft to classify all inbound documents, determine document types, and as you’ll see whether any missing documents End – if time – show the approval process
  14. Our History / Our Focus We do content – not just any content, but critical. With a focus on process-intensive content Take our skills and build repeatable solutions on open platforms To again help you control your chaos and automate your manual/paper-centric processes
  15. Across the industry – case studies: Citizens – Property Insurance in cat prone area – as discuss in the case earlier – realized many of claims costs came prior to interaction w/ claims management system Global Insurance Holding Co – P&C, Life, Life Reinsurance – ephesoft to address paper problem in claims processing Across your organization Applications to claims But also contracts / ap – as discuss in next webinar – or even HR Also discuss in next webinar – Policy issuance, legal – document assembly – partner who works with many of the largest legal organizations in ther world Talked about outlook – but also solutions for sharepoint & office 365, and again next time cover integrations with items like SAP & Dynamics And as mentioned, our Active Migrate methodology which we’ve used to move hundreds of millions of documents into Alfresco
  16. Where go from here – First – if this might be a fit – let’s talk – talk to us / happy to have you talk to customers Look at your claims process, show you more depth the solution Visit our web page, few other demos And we’d welcome you on our next couple of webinars With 3rd one covering both internal data security but also what to look at when providing cyber coverage
  17. Where go from here – First – if this might be a fit – let’s talk – talk to us / happy to have you talk to customers Look at your claims process, show you more depth the solution Visit our web page, few other demos And we’d welcome you on our next couple of webinars With 3rd one covering both internal data security but also what to look at when providing cyber coverage
  18. Across the industry – case studies: Citizens – Property Insurance in cat prone area – as discuss in the case earlier – realized many of claims costs came prior to interaction w/ claims management system Global Insurance Holding Co – P&C, Life, Life Reinsurance – ephesoft to address paper problem in claims processing Across your organization Applications to claims But also contracts / ap – as discuss in next webinar – or even HR Also discuss in next webinar – Policy issuance, legal – document assembly – partner who works with many of the largest legal organizations in ther world Talked about outlook – but also solutions for sharepoint & office 365, and again next time cover integrations with items like SAP & Dynamics And as mentioned, our Active Migrate methodology which we’ve used to move hundreds of millions of documents into Alfresco