mis #4 slideshow
Post on 14-Jun-2015
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WHAT WE DO…
CUSTOMERS
• Businesses• Associations• Individuals
CUSTOMER CLAIM PROCESS
$$$
LIFE OF A CLAIM
THE MAIL ROOM
SCANNING
What IS that?!
SCANNING PROCESS
DATA ENTRY
Slow &
Tedious
Two Words:
ADJUDICATION
Match Data & Receipts
Reconcile
Check Plan
or
CLAIM CLOSING CENTER
$X
SO WHAT?
BOT⋅TLE⋅NECK
–noun: a place or stage in a process at which progress is impeded
THE PROBLEM
• Mail Received• Sorted• Claims sent to scanning department
•Labor: N/A
• Separate claims from receipts• Scan claims into database
• Labor: 7 FTE’s & 1 QC
ADJUDICATION
• Separate claims & receipts• Scan claims into database
•Labor: 7 FTE 1 QC
• Match database with receipts• Enter receipts and claim info
•Labor: 15 FTE
• Review claim & match with client policy• Accept/Reject claim
•Labor: 100 FTE
• Process payment
•Labor: 10 FTE
Labour $$ 841kDirect $$ 90kTotal $$ 931k
WHAT TO FIX…
• Inefficient
• Expensive
• Error Prone
WHAT DO WE DO?
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