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LEVERAGING
INTERNAL SYSTEMS
AND INTEGRATION
By Duane L. Nicholson, M.B.A.
Principal Consultant, N.B.D. Consulting Services
Product & Solution
The Scheduled Increase Rider allows clients to purchase
the option to increase coverage in specific time periods in
the future. Due to concerns about anti-selection, the
product was modified to require increases at given
intervals or the client risks forfeiture of future increases.
In addition, this rider allows for automatic increases
without medical underwriting but still requires financial
underwriting for suitability purposes.
Business Problems
• Business model uses an independent producer channel that has
strong relationship with the client. So, producer involvement is
key to the process.
• Clients often don’t respond to correspondence in a timely
manner.This further supports the need to have producer
involvement.
• What should be done when incomplete paperwork is received?
• Mainframe and Documaker/Documerge are independent of
other systems (e.g., PPT, Workflow)
Objective & Requirements
Objective
Send correspondence to
client and have the ability
to communicate status of
client request.
High-Level Requirements
• Send correspondence 60 days in
advance of increase to allow client
time to gather and complete forms.
• Engage the producer to help facilitate
a timely response form the client.
• Modify workflow process to accept
new documents and respond
accordingly to an incomplete
response.
Internal Systems
Notification and Alert Process Flow – Internal Systems
Filenet/Printer
DocumentControl
Repository
Correspondence
Tool
DocumakerMainframe
10/1/2010 2/1/2011
11/1/2010 12/1/2010 1/1/2011
Reminder Package
Disclosure
HIPAA
SuppApp
CoverLetter
Notification Package
Disclosure
HIPAA
SuppApp
CoverLetter
Trigger Notification
Letter
CSV Extract
Commit to Filenet
and Mail
A
Disclosure
HIPAA
SuppApp
Generate Alert
C
B
F
Trigger Reminder
Letter
CSV Extract
Disclosure
HIPAA
SuppApp
Response
Received?
H
Stop
Yes
No
Generate Alert
Create AWD Work
Item
I
J
K
NCommit to Filenet
and Mail
This diagram illustrates how the
mainframe sends a file to Documaker.This
file then converts that file into a .csv file
that is consumed by the Correspondence
Tool.
The CorrespondenceTool was leveraged
since it was already being used with the
commission systems to send out producer
notifications.
The CorrespondenceTool then pulls
documents from a document repository
and creates a package and store these in
Filenet so that the Customer Service
teams would know what was sent to the
client. At the same time, these documents
are forwarded to the client 60 days in
advance of the scheduled increase. The
CorrespondenceTool provides the bridge
between all systems.
Notification and
Process Flows
Notification and Alert Process Flow – Workflows & Alerts
WebPortalAlertStoredProcedureWorkflowSystem
A
Execute Stored
Procedure – Send
Notification Alert
Display Alert
Send Notification
Alert
D
10/1/2010 2/1/2011
11/1/2010 12/1/2010 1/1/2011
E
Execute Store
Procedure –
Response Received
Execute Stored
Procedure –
Change Alert Status
to Inactive
Display Alert
Doc Received?
Doctype
Received?
Create Doctype
AWD Work Item
Yes
Send to AbeyanceG
D
H
Send Reminder
Alert
Display Alert
Execute Stored
Procedure – Send
Reminder Alert
Doc Received?
Display Alert
Create Doctype
AWD Work Item
Send to Abeyance
Execute Stored
Procedure –
Change Alert Status
Doctype
Received?
Execute Store
Procedure –
Response Received
I
L
M N
O
L
P
Stop
Yes
No
No
Yes
Yes
No
No
This is a manual
process completed
by the user.
This is a manual
process completed
by the user.
Once correspondence is sent to the client,
a store procedure is forwarded to the web
portal that turns on the alert for the
producer.This gets the producer to engage
with the client in the process.
This section describes what happens if the
client responds to the request.
Documents are scanned for codes that
identify the type of document (doctype)
and automatically sends these items to
the client services team for processing the
increase request.
A stored procedure is sent to the Workflow
systems 30 days prior to the increase
request to see if all requirements are
received. If received, it turns off the Alert.
Otherwise, another Alert is generated.
Client Facing
Items
Notification and Alert Process Flow – Client Facing
ClientProducerCustomerService
C
B
Notification
Package
Received
Notification
Package
Received
D
Response?
10/1/2010 2/1/2011
11/1/2010 12/1/2010 1/1/2011
E
Yes
F
G
Contact Client
No
Notification
Alert
Response?
Contact ClientL
Reminder
eAlert
Incomplete Correspondence
Assumes any
response
regardless if the
response is
incomplete.
J
Reminder
Package
Received
K
Reminder Package
Received
M
Yes
Assumes any
response
regardless if the
response is
incomplete.
O
Incomplete Correspondence
P
No
This diagram shows the Alerts as described
previously as well as what happens when
the response is received or not received
from the client.
If the client, doesn’t respond with
complete information the process restarts
on the scheduled increase date as outline
in the purple color diagram shapes.
Internal Systems:
Response not
Received.
Notification and Alert Process Flow – Internal Systems
Filenet/Printer
DocumentControl
Repository
Correspondence
Tool
DocumakerMainframe
10/1/2010 2/1/2011
11/1/2010 12/1/2010 1/1/2011
Reminder Package
Disclosure
HIPAA
SuppApp
CoverLetter
Notification Package
Disclosure
HIPAA
SuppApp
CoverLetter
Trigger Notification
Letter
CSV Extract
Commit to Filenet
and Mail
A
Disclosure
HIPAA
SuppApp
Generate Alert
C
B
F
Trigger Reminder
Letter
CSV Extract
Disclosure
HIPAA
SuppApp
Response
Received?
H
Stop
Yes
No
Generate Alert
Create AWD Work
Item
I
J
K
NCommit to Filenet
and Mail
The process begins the same, except that
it requires associate intervention. This is
why a work item is created requiring a
client services associate to get involved
and to expect new documents.
Notification and
Process Flows
Notification and Alert Process Flow – Workflows & Alerts
WebPortalAlertStoredProcedureWorkflowSystem
A
Execute Stored
Procedure – Send
Notification Alert
Display Alert
Send Notification
Alert
D
10/1/2010 2/1/2011
11/1/2010 12/1/2010 1/1/2011
E
Execute Store
Procedure –
Response Received
Execute Stored
Procedure –
Change Alert Status
to Inactive
Display Alert
Doc Received?
Doctype
Received?
Create Doctype
AWD Work Item
Yes
Send to AbeyanceG
D
H
Send Reminder
Alert
Display Alert
Execute Stored
Procedure – Send
Reminder Alert
Doc Received?
Display Alert
Create Doctype
AWD Work Item
Send to Abeyance
Execute Stored
Procedure –
Change Alert Status
Doctype
Received?
Execute Store
Procedure –
Response Received
I
L
M N
O
L
P
Stop
Yes
No
No
Yes
Yes
No
No
This is a manual
process completed
by the user.
This is a manual
process completed
by the user.
Essentially this process works the same
except that the a stored procedure is sent
to the Workflow systems the day of the
scheduled increase. If received, it turns off
the Alert. Otherwise, another Alert is
generated.
If no response is received from the client
60 days after the scheduled increase, the
Alert is turned off.
Client Facing
Items
Notification and Alert Process Flow – Client Facing
ClientProducerCustomerService
C
B
Notification
Package
Received
Notification
Package
Received
D
Response?
10/1/2010 2/1/2011
11/1/2010 12/1/2010 1/1/2011
E
Yes
F
G
Contact Client
No
Notification
Alert
Response?
Contact ClientL
Reminder
eAlert
Incomplete Correspondence
Assumes any
response
regardless if the
response is
incomplete.
J
Reminder
Package
Received
K
Reminder Package
Received
M
Yes
Assumes any
response
regardless if the
response is
incomplete.
O
Incomplete Correspondence
P
No
This diagram shows the Alerts as
described previously as well as what
happens when the response is received
or not received from the client.
If the client doesn’t respond with
complete information, the process
restarts on the scheduled increase date
as outline in the purple color diagram
shapes.
Solution Results
Problems
• Business model uses an independent
producer channel that has strong
relationship with the client. So, producer
involvement is key to the process.
• Clients often don’t respond to
correspondence in a timely manner.This
further supports the need to have producer
involvement.
• What should be done when incomplete
paperwork is received.
• Mainframe and documaker/documerge are
independent of other systems (e.g., PPT,
Workflow)
Solution
• Utilize eAlert functionality to stimulate
the producer to engage with the Client.
• Correspondence sent 60 days in advance
and day of scheduled increase.
• Workflow system engages client services
team to follow up with client.
• Leverage Correspondence tool outside of
commission processes to bridge
mainframe & correspondence and web
portal.
Contact…
N.B.D. Consulting Services to
leverage existing systems in
your organization.
Call (949-328-6093)
or visit
http://www.nbdmcs.com

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Leveraging internal systems and integration

  • 1. LEVERAGING INTERNAL SYSTEMS AND INTEGRATION By Duane L. Nicholson, M.B.A. Principal Consultant, N.B.D. Consulting Services
  • 2. Product & Solution The Scheduled Increase Rider allows clients to purchase the option to increase coverage in specific time periods in the future. Due to concerns about anti-selection, the product was modified to require increases at given intervals or the client risks forfeiture of future increases. In addition, this rider allows for automatic increases without medical underwriting but still requires financial underwriting for suitability purposes.
  • 3. Business Problems • Business model uses an independent producer channel that has strong relationship with the client. So, producer involvement is key to the process. • Clients often don’t respond to correspondence in a timely manner.This further supports the need to have producer involvement. • What should be done when incomplete paperwork is received? • Mainframe and Documaker/Documerge are independent of other systems (e.g., PPT, Workflow)
  • 4. Objective & Requirements Objective Send correspondence to client and have the ability to communicate status of client request. High-Level Requirements • Send correspondence 60 days in advance of increase to allow client time to gather and complete forms. • Engage the producer to help facilitate a timely response form the client. • Modify workflow process to accept new documents and respond accordingly to an incomplete response.
  • 5. Internal Systems Notification and Alert Process Flow – Internal Systems Filenet/Printer DocumentControl Repository Correspondence Tool DocumakerMainframe 10/1/2010 2/1/2011 11/1/2010 12/1/2010 1/1/2011 Reminder Package Disclosure HIPAA SuppApp CoverLetter Notification Package Disclosure HIPAA SuppApp CoverLetter Trigger Notification Letter CSV Extract Commit to Filenet and Mail A Disclosure HIPAA SuppApp Generate Alert C B F Trigger Reminder Letter CSV Extract Disclosure HIPAA SuppApp Response Received? H Stop Yes No Generate Alert Create AWD Work Item I J K NCommit to Filenet and Mail This diagram illustrates how the mainframe sends a file to Documaker.This file then converts that file into a .csv file that is consumed by the Correspondence Tool. The CorrespondenceTool was leveraged since it was already being used with the commission systems to send out producer notifications. The CorrespondenceTool then pulls documents from a document repository and creates a package and store these in Filenet so that the Customer Service teams would know what was sent to the client. At the same time, these documents are forwarded to the client 60 days in advance of the scheduled increase. The CorrespondenceTool provides the bridge between all systems.
  • 6. Notification and Process Flows Notification and Alert Process Flow – Workflows & Alerts WebPortalAlertStoredProcedureWorkflowSystem A Execute Stored Procedure – Send Notification Alert Display Alert Send Notification Alert D 10/1/2010 2/1/2011 11/1/2010 12/1/2010 1/1/2011 E Execute Store Procedure – Response Received Execute Stored Procedure – Change Alert Status to Inactive Display Alert Doc Received? Doctype Received? Create Doctype AWD Work Item Yes Send to AbeyanceG D H Send Reminder Alert Display Alert Execute Stored Procedure – Send Reminder Alert Doc Received? Display Alert Create Doctype AWD Work Item Send to Abeyance Execute Stored Procedure – Change Alert Status Doctype Received? Execute Store Procedure – Response Received I L M N O L P Stop Yes No No Yes Yes No No This is a manual process completed by the user. This is a manual process completed by the user. Once correspondence is sent to the client, a store procedure is forwarded to the web portal that turns on the alert for the producer.This gets the producer to engage with the client in the process. This section describes what happens if the client responds to the request. Documents are scanned for codes that identify the type of document (doctype) and automatically sends these items to the client services team for processing the increase request. A stored procedure is sent to the Workflow systems 30 days prior to the increase request to see if all requirements are received. If received, it turns off the Alert. Otherwise, another Alert is generated.
  • 7. Client Facing Items Notification and Alert Process Flow – Client Facing ClientProducerCustomerService C B Notification Package Received Notification Package Received D Response? 10/1/2010 2/1/2011 11/1/2010 12/1/2010 1/1/2011 E Yes F G Contact Client No Notification Alert Response? Contact ClientL Reminder eAlert Incomplete Correspondence Assumes any response regardless if the response is incomplete. J Reminder Package Received K Reminder Package Received M Yes Assumes any response regardless if the response is incomplete. O Incomplete Correspondence P No This diagram shows the Alerts as described previously as well as what happens when the response is received or not received from the client. If the client, doesn’t respond with complete information the process restarts on the scheduled increase date as outline in the purple color diagram shapes.
  • 8. Internal Systems: Response not Received. Notification and Alert Process Flow – Internal Systems Filenet/Printer DocumentControl Repository Correspondence Tool DocumakerMainframe 10/1/2010 2/1/2011 11/1/2010 12/1/2010 1/1/2011 Reminder Package Disclosure HIPAA SuppApp CoverLetter Notification Package Disclosure HIPAA SuppApp CoverLetter Trigger Notification Letter CSV Extract Commit to Filenet and Mail A Disclosure HIPAA SuppApp Generate Alert C B F Trigger Reminder Letter CSV Extract Disclosure HIPAA SuppApp Response Received? H Stop Yes No Generate Alert Create AWD Work Item I J K NCommit to Filenet and Mail The process begins the same, except that it requires associate intervention. This is why a work item is created requiring a client services associate to get involved and to expect new documents.
  • 9. Notification and Process Flows Notification and Alert Process Flow – Workflows & Alerts WebPortalAlertStoredProcedureWorkflowSystem A Execute Stored Procedure – Send Notification Alert Display Alert Send Notification Alert D 10/1/2010 2/1/2011 11/1/2010 12/1/2010 1/1/2011 E Execute Store Procedure – Response Received Execute Stored Procedure – Change Alert Status to Inactive Display Alert Doc Received? Doctype Received? Create Doctype AWD Work Item Yes Send to AbeyanceG D H Send Reminder Alert Display Alert Execute Stored Procedure – Send Reminder Alert Doc Received? Display Alert Create Doctype AWD Work Item Send to Abeyance Execute Stored Procedure – Change Alert Status Doctype Received? Execute Store Procedure – Response Received I L M N O L P Stop Yes No No Yes Yes No No This is a manual process completed by the user. This is a manual process completed by the user. Essentially this process works the same except that the a stored procedure is sent to the Workflow systems the day of the scheduled increase. If received, it turns off the Alert. Otherwise, another Alert is generated. If no response is received from the client 60 days after the scheduled increase, the Alert is turned off.
  • 10. Client Facing Items Notification and Alert Process Flow – Client Facing ClientProducerCustomerService C B Notification Package Received Notification Package Received D Response? 10/1/2010 2/1/2011 11/1/2010 12/1/2010 1/1/2011 E Yes F G Contact Client No Notification Alert Response? Contact ClientL Reminder eAlert Incomplete Correspondence Assumes any response regardless if the response is incomplete. J Reminder Package Received K Reminder Package Received M Yes Assumes any response regardless if the response is incomplete. O Incomplete Correspondence P No This diagram shows the Alerts as described previously as well as what happens when the response is received or not received from the client. If the client doesn’t respond with complete information, the process restarts on the scheduled increase date as outline in the purple color diagram shapes.
  • 11. Solution Results Problems • Business model uses an independent producer channel that has strong relationship with the client. So, producer involvement is key to the process. • Clients often don’t respond to correspondence in a timely manner.This further supports the need to have producer involvement. • What should be done when incomplete paperwork is received. • Mainframe and documaker/documerge are independent of other systems (e.g., PPT, Workflow) Solution • Utilize eAlert functionality to stimulate the producer to engage with the Client. • Correspondence sent 60 days in advance and day of scheduled increase. • Workflow system engages client services team to follow up with client. • Leverage Correspondence tool outside of commission processes to bridge mainframe & correspondence and web portal.
  • 12. Contact… N.B.D. Consulting Services to leverage existing systems in your organization. Call (949-328-6093) or visit http://www.nbdmcs.com