business process management an overview of practice at blue cross and blue shield of nebraska...

Business Process Management

An Overview of Practice at

Blue Cross and Blue Shield of Nebraska

Process Management Process Management

Process Design

Process Design

Pro

cess

Impr

ovem

ent

Pro

cess

Impr

ovem

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Presentedby:

Bob Tippett, Director of Business Process Engineering

Rich Rozgay, Director of Six Sigma

Process Management Process Management

Process Design

Process Design

Pro

cess

Impr

ovem

ent

Pro

cess

Impr

ovem

ent

Agenda BPM, BPE and Lean Six Sigma Implementation Strategies BPE at BCBSNE Lean Six Sigma at BCBSNE Synergies of BPE and Lean Six Sigma Lessons Learned Open Discussion / Q&A

BPM at BCBSNE• Methods

– Business Process Engineering– Lean / Six Sigma– Value Chain Analysis

• Tools– Microsoft Office Suite (Documentation, Analytics and

Toolkits)– Microsoft Share Point (Collaboration) – Enterprise Architecture Sparx (Process Modeling w/ BPMN)

• Technologies– Service Oriented Architecture (SOA)– Off - the - Shelf– Business Process Management Suite (BPMS)

Implementation Strategies• Lots of Options – You Need to Understand:

– Culture – ready for change?– Organizational Risk Appetite – mistakes are opportunities to learn– IT Environment – resources and systems accessible to projects – Available Professional Expertise – lots of new skills and knowledge– Available Tools and Methods – integration and ownership

• Executive Driven PI - Top Down– Broad in Scope (Corporate)– Long timeline and big $$$ commitment (3-5 years, millions of $)– Broad organizational impact

• Mid-Level Management Driven PI– Narrower Scope (Divisional / Departmental)– More flexibility to manage outcomes, easier to gain agreement for action– Constrained organizational impact

• Grass Roots PI – Bottom Up– Tightly Focused Scope (Department / Workgroup)– Full control of goals and objectives, resources and outcomes– Narrow organizational impact

What is BPM?Business Process Management (BPM) is a set of methods, tools and technologies used to design, enact, analyze and control operational business processes.

- SoftwareAG

What is Lean Six Sigma (6σ)?Lean Six Sigma for services is a business improvement methodology that maximizes shareholder value by achieving the fastest rate of improvement in customer satisfaction, cost, quality, process speed, and invested capital.

- California State University

What is BPE?The analysis and re-design of business processes and associated technology systems, with the goal to eliminate or reduce redundancy and streamline interactions.

- Deputy Undersecretary of the Army

The “Super System” - Rummler

Copyright © 2006. Performance Design Lab. All Rights Reserved.

Business Process Engineering• American Productivity and Quality

Council (APQC) Process Classification FrameworkSM (PCF) provides an industry-neutral framework•The first version of the BCBSNE EBPM. All EBPM reflected the generic nature of the APQC PCF.

Copyright © 1994-2009 All Rights Reserved.

BCBSNE Enterprise Process Model

EBPM Process Categories• Core Processes

– Processes that are essential to creating value for customers

– All customer-facing processes – Processes which develop, sell and deliver

products/services to the company’s markets– Litmus test: “Did the company go into business to do

this?”– Differentiation in these processes is the key to creating

(and potentially sustaining) competitive advantage for the company

• Governing Processes– Provide guidance and direction to other processes

• Enabling Processes– Create key capabilities for core processes

• Supporting Processes– Provide resources and services to other processes– Provide no direct inputs to customers– These processes are performed by every company in

every industry– Primary objective for these processes is effectiveness and

efficiency

2.0Develop Health and Wellness

Solutions

2.0 Develop Health and Wellness Solutions• Formerly “Design and Develop Products

and Services”• This category contains processes

related to designing, developing, implementing and managing health and wellness solutions that the company provides to the market. It begins with the idea for a health and wellness solution and ends with the implementation of a marketable health and wellness solution. It includes the following:

– Researching and conceiving new health and wellness solutions

– Designing health and wellness solutions, including pricing

– Obtaining regulatory approval for health and wellness solutions

– Introducing health and wellness solutions into the company’s target markets

– Implementing health and wellness solutions into business operations, including establishing the capability to sell and administer the solutions through the company’s processes and systems

– Conducting ongoing management of the company’s portfolio of health and wellness solutions

3.0 Market and Sell Health and Wellness Solutions

• Formerly “Market and Sell Products and Services”

• This category contains processes related to bringing the company’s health and wellness solutions to the markets it serves through all distribution channels. It deals with activities from initial contact with a potential prospect through the point of sale. It includes the following:

– Developing and managing sales strategy

– Managing sales opportunities and pipeline, including handling requests for proposal

– Developing and executing advertising campaigns

– Establishing and maintaining relationships with distribution channels (e.g. brokers)

– Managing new and renewal sales through all distribution channels

3.0Market and Sell

Health and Wellness Solutions

4.0 Fulfill Health and Wellness Solutions• Formerly “Deliver Products and

Services”• This category contains

processes related to carrying out the sale of the company’s health and wellness solutions. It deals with activities from the point of sale through fulfillment. It establishes prospective groups and members as customers. It includes the following:

– Handling new and renewal business applications

– Analyzing risk (including medical review) and the communication of risk analysis results

– Managing group and member enrollment

– Administering physical fulfillment (e.g. generation and delivery of insurance policies, ID cards)

4.0Fulfill Health and

Wellness Solutions

5.0 Service the Customer• This category contains

processes related to providing service to the company’s customers (directly or indirectly) and those acting on behalf of customers (e.g. providers, brokers, employee benefit plan administrators, and partners). It includes the following:

– Managing the customer relationship

– Responding to all service requests (e.g. inquiries, problems) related to the ongoing service of health and wellness solutions

– Proactively providing service

– Providing first- and second-level customer support

– Administration of claims

5.0Service the Customer

Process Hierarchy at BCBSNE

Level 1 - Enterprise Processes (12)

Level 2 - Process Group (50+)

Level 3 - Business Process (250+)

Level 4 - Sub Process (1000+)

Steps/Procedures (10000+)

Increasing Detail,Narrowing Scope

Decreasing Detail,Broadening Scope

BCBSNE EBPM Level 1BPMN Enterprise Business Process Model

«Group»Enabling Processes

«Group»Supporting Processes

«Group»Core Processes (Value Chain)

«Group»Governing Processes

«Pool»

BlueC

ross BlueShield of N

ebraska

Develop Health andWellness Solutions

Market Health andWellness Solutions

Administer HumanResources and

Services

Set Strategic andOperational Direction

Fulfill Health andWellness Solutions

Service the Customer

AdministerInformationTechnology

Resources andServices

Administer FinancialResources and

Services

Administer CorporateRelations

Administer BusinessPerformance

Administer ProviderNetworks

Administer PhysicalResources and

Services

MarketableHealth andWellnessSolutions

Agreementto Purchase

Direction

Direction

EstablishedMembers andGroups

Feedback

Feedback

BCBSNE EBPM Level 2BPMN Service the Customer

«P

ool»

BCB

SN

E

«Lane»

VP

, Pharm

acy

«Lane»

SV

P, C

laim

s«

Lane»

VP

, Mem

ber S

erv

ices

Start Service the Customer

Develop CustomerRelationship

Management Strategy

Administer ServiceRequests

End Service the Customer

Administer Claims

Plan and ManageCare

Administer Pharmacy

BCBSNE EBPM Level 3BPMN Plan and Manage Care

«Pool»

BCB

SN

E

«Lane»

Start Plan & Manage Care

Develop & MaintainMedical Policies

Develop MedicalManagement Strategy

End Plan &Manage Care

Provide MedicalReview

Manage Claims,Authorizations, &

Precerts

Manage Appeals &Grievances

Perform CaseManagement

Manage DiseasePrograms

Manage WellnessPrograms

Provide OutreachPrograms

Evaluate Outcome &Report Performance

BCBSNE EBPM Level 4BPMN Manage Authorizations & Precerts

«P

ool»

BCB

SN

E

«Lane»

Health

Serv

ice P

rogra

ms (

HSP)

«Lane»

Medic

al S

upport D

epartm

ent (

MSD

)

Records

LOI Letter Sent byCoreLink to Member

/ Provider

Prior Approvals

PreAuths

Phone

- E-mail- FaxMaker- Letter- Thor- WiseGUI

Start Manage Authorizations and Precerts

Receive Request /Claim

Route

Make Decision(CCMS)

Pend for More Info(CCMS)

Update System(CCMS)

Send AppropriateLetter to Member,

Provider, &Institution (CCMS)

Receive Info

Internal or ExternalPhysician Review

Route toApppropriate Nurse

(CCMS)

Close Out Event(CCMS)

End Manage Preauthorizations & Prior Approvals

Claim

Receive Claim fromMacess

Forward to CSC

End Manage Authorizations & Prior Approvals

Make & DocumentDecision (CCMS)


Internal or ExternalPhysician Review

Receive Info (CCMS) Pend For More Info(CCMS)

Update System(CCMS)

Denial


Send AppropriateLetter to Member,

Provider, &Institution (CCMS)

Close Out Event on(CCMS)

End Manage Preauthorizations & Prior Approvals

Creates Case File(CCMS)

Create Case Note(CCMS)

Case Notes & Claim

Nurse ReviewerReviews Decision

Reviewed Docs

Is this a Med Necessity Denial?

Nurse Composes MedNecessity Denial

Letter on CoreLinkLetter GUI

Send Letter viaCoreLink Letter GUI

Nurse DocumentsDecision on CoreLink

Notes ScreenEnd Manage Claims

Claim Pended not toExceed 47 / 50 Days

Rationale Received Within 47 / 50 Days?

Rationale is Acceptedon Letter GUI by

Pending Clerk (MRU)

Is This a Medical Necessity Review?

CoreLink SystemAuto Denies for NoAnswer to Inquiry

Generate Report

End Manage ClaimsLetter

End Manage Claims

Records Reffered toIIC

Records

Records Receivedfrom IIC

Nurse Notified ofRationale Update

(Macess)

Payment

PaymentDenial

Requested Info Info Request

Requested Info Info Request

Review Claim and AllAvailable Information

1st or 2nd Level Review?

Document on NotePortion of CoreLink

Claims / MacessEnd Manage Claims

Days

Rationale is Requestedfrom Provider/Plan

Days

Attach by MTM orDOL with OriginalClaim & Inserts

Look in BlueBridge(Coverage Inquiry)

Advise Non-Member

Eligible for Service?

End Manage Authorizations &Precerts

Review History &Criteria

Review Documents

SearchDocumentation

Search Medical PolicyManual

Review History(Macess, CCMS,

Track)

Review Documents

Store Letter Image inMacess

- CoreLink Blue2 - Letter is being sent via CoreLink Letter GUI

- Nurse Reviewer Creates Case Note on CCMS and Refers to Physician via CCMS


Return Claim toAuditor (Via Macess)

Claim

Look for Eligibility Claim / Retro Review or Prior Approval / Preauthorization?

Send to MSD

Claim

End

Create Event (CCMS)

Search in BlueBridge (Benefit Matrix), Documentation Search,& Procedure & Diagnosis Code Lookup (Eagle).

Approval

Forward via FaxMaker or WiseGUI

Review Request


MSD or MPR?Send to MPR

Claim

Create Note

Search in BlueBridge (Benefit Matrix), Documentation Search, & Procedure & Diagnosis Code Lookup (Eagle).

Attach to claim in CoreLink system(s).

Note contains logic for auditors to make decisions.

Letter

The CoreLink system does this automitically

Reminders are send out at 15 and 47 days

Existing Review?

Status of claim changes from pending / investigative status to openat which point the claim is pulled into the Macess docflow.

Records received after close date?

Update CoreLinkBlue2

Home claim only

Reinventory Claim

Claim is resent to Macess at this point

Report generated by Med Necess RNA

Nurse reviewer creates case file on CCMS / Note on Claim (CoreLink)

Need ActiveX script for this step

Needs to be built

«Lane»

Medic

al P

re-R

evie

w (

MP

R)

Receive Claim fromMacess

Update Claim Send to MedicalReview

Claim

Claim Pended not toExceed 47 / 50 Days

Review Claim and AllAvailable Information

Pay/Deny, Pend, or Med Review?

Document on NotePortion of CoreLink

Claims / MacessEnd Manage Claims

Days

Rationale is Requestedfrom Provider/Plan

Days

Attach by MTM orDOL with OriginalClaim & Inserts

- CoreLink Blue2 - Letter is being sent via CoreLink Letter GUI

Create Note

Search in BlueBridge (Benefit Matrix), Documentation Search, & Procedure & Diagnosis Code Lookup (Eagle).

Attach to claim in CoreLink system(s).

Note contains logic for auditors to make decisions.

Letter

The CoreLink system does this automitically

Reminders are send out at 15 and 47 days

Existing Review?

Need ActiveX script for this step

- Use work in progress queue with attachments.- Use round robin assignment (Fair Square / Balanced Workload) and direct assignment to an individual.

MBS, Macess, Eagle, InterQual, Value Option

Use Reminderfor managingopen events.

If response is received after 48hrs., the event isreopened

Info Received in 48 hrs.?

Close Event (CCMS)

End Manage Authorizations & Precerts

- Address supression check- Dependent age check

Route using Reminder

Routed to 1st level reviewer via WIP

Forward toAppropriateDepartment(WiseGUI)

- Update notes in MBS prior to batch cycle. Notes are locked after batch cycle.

- This information is also updated in the claims system (Eagle)

Response Received in 50 Days?

Send LOI Letter &Close Event (CCMS)

End Manage Authorizations & Precerts

LOI Letter

- Address supression check- Dependent age check

Call Provider and / orMember

Phone Update

- Update notes in MBS prior to batch cycle. Notes are locked after batch cycle.

- This information is also updated in the claims system (Eagle)

Route using ReminderRouted to 1st level reviewer via WIP

Prior Approval(FormerlyPreAuth)

No

1st Level

Yes

No

2nd Level

Pay

Pend

CSC PriorApproval

2ndLevelReview

Pay

Pend

Misroutes

Pend

Yes

No

MedReview

Yes

Existing

MPR

Claim / RetroReview

MedicalPriorApproval

Prior Approval /Preauthorizations

MSD

Yes

Yes

No

No

Yes

No

PreAuth(FormerlyPrecert)

Pay / Deny

No

No

Yes

2ndLevelReview

Yes

No

Yes

The Organizational Status Quo

“The only things that evolve by themselves in an organization are disorder, friction, and mal-performance.”

- - Peter Drucker

Lean Six Sigma at BCBSNE• Where We Are With Lean 6σ• Where We Are Going• How We’ll Get There

Where Are We with Lean 6σ

Our processes are sometimes inconsistent and / or inefficient = too much manual work

Our organization is under stress Competition (lonely at the top) Resources Constraints Mandates and CoreLink Constraints

We all have the formal or informal responsibility to improve our processes

“Better, Faster, Cheaper, NOW!”

Where Are We Going? Half of getting where you are going is knowing where you are getting

Streamlined processes will improve our flexibility, lower resource requirements and improve morale

We work in a target-rich environment

How Are We Going to Get There? Six Sigma

Six Sigma reduces variation in processes Requires high level of expertise and reliable

data Very effective in certain situations

Lean Six Sigma Hybrid approach designed to provide the best

of both worlds Does it work? The debates rage on!

Problem Solving Process Quick way to solve a specific issue or problem

The Process Mindset

“If you can't describe what you are doing as a process, you don't know what you're

doing.” --W. Edwards Deming

Core of Engineering Process Example

Y

No/Maybe

A ApplicationComplete

Letter or Phone Call to Applicant

I

I

Recv. Add. Info

Public NoticeDrafted

Public Notice Issued

I I

Corp Review Comment Ltr

Ltr to Appl.

I I

Water Quality Certif

Endangered Species

Cultural/Tribal

EssentialFish Habitat

I

I

I

I

I

Assess ESA info.

Review Response

IncompleteI

Decision Document

I

Services ReviewEffect?

I

Contact Applicant

Complete?

II

Consultation and Draft BD

Appl and Corp Review draft

BO

Service Completes BO

I

Indvidual Permit Process

Coord w/ Arch/Corps,

Cultural Resources

Complete?

N

Sec 106 Determ

I

Effect? GenerateLtrs

IY Maybe

SHPO Rev Sec 106

Complete?

INN

SHPO DraftsMOA

Corps forwards

MOA to Tribes

Corps forwards

MOA to SHPO

SHPO signs MOA

MOA Complete

Coastal Zone Mgt.

N

Y

B

External Organization

Ledgend

B

I

Draft Decision Doc and

Permit Ltr. I

Sec ChiefReview

80%

Branch Chief/Distr Eng.Review

Put in Final Form

Permit Decision Issued

Applicants

I I

Indvidual Permit Process

Applicant Sign

Corps Sign

Value Statement

Timely issuance of a permit decision that

comply with Federal laws and regulations and, if a permit is issued, enables the applicant to proceed with a practicable project

Key Requirements

Domestic Statutory and Regulatory Requirements

Measurements

· Turn-a-round Time – i.e. elapsed time from date application is

received to permit issued Goal is 100% within 120 days

· Total Application Backlog - i.e. number of applications in process

and/or waiting to be processed at any given time. Goal is to reduce by 50%

· First Pass Yield of Applicant Submittals – Percent Complete and

accurate the first time. Goal is to increase FPY to <90%

Ideal State

· On-Demand· Defect Free· 1-By-1· Lowest Cost

Applicant

Sec Chief assigns to PM

PM Review for completeness

Complete? Yes

No

Csll/Email Applicant

for more info.

Receive Additional

Applicant Info

25%

75%

Site Visit Office Visit

Field Visit

Develop Disclaimer Letter

Verify Delineatio

n

Sec Chief Review

Office of Council Review

No permit or Jurisdiction Required

PM Issues Letter

Letter Developed

JDs

I

I

I

I

I

I

I

I

I

Set up Field Visit Verify

Letter Developed

More Info.

Field Visit

N

Y

I

PM SignsLetter

Applicant Appeals

I

1%I

Send Additional Info to District I

I

2nd

Applicant Appeal

Admin Records Prep

Division ReviewAppeal

Mtg.

Division Process Correct

YII

I

I

IICourt and/or

AppealI

Review Application

30%

A

Jurisdictional Determination

Business Case

In light of increasing workload and complexity

associated with the regulatory program, efficiency must be

increased to maintain the quality of permit decisions

Total Cycle Time = 152 - 383 days Total Touch Time = 105 - 132 Hrs

Total Cycle Time = 152 - 383 days Total Touch Time = 105 - 132 Hrs

Categories of Process Activities

Customer Value Add (VA) Any activity in a process that is

essential to deliver a service to the customer

Business Value Add (BVA) Activities that are required by the

business but add no real value from a customer standpoint

Non-Value Add (NVA) Everything else!

Typically the largest contributor to process cycle time is non-value add activities, while the smallest contributor is Customer Value

Add activities

Process Cycle Time Process Cycle Time (PCT) is the total

time to complete an activity or process.- e.g., complete application, load the

member & pay the claim

VAVA Business Business Value AddValue AddNon-Value Add Non-Value Add

1. Waste of Overproduction

2. Waste of Time (Idle)

3. Waste in Transportation

4. Waste of Processing

5. Waste of Inventory

6. Waste of Movement

7. Waste of Making Defective Products

8. Waste is the Waste of People – Ignoring their ideas!!!! 8th

Lean Eliminates Waste

How Do We Get There?

Be Mindful of Counter intuitive fixes!

We train people and ignore process

We improve VA steps when the problem is NVA

Value Stream Analysis (VSA) / Lean Deliverables

Current Process Map - Where are we now Future Process Map - Where are we going Action Plan to Achieve the Future - How are we going to get there Implementation Guidance

- Procedures which are the future rules drafted by those who will have to use them

Lean Mapping Basics Mapping is about the process, not the

software

Everything is serial for your process. If you think there is a parallel event occurring, think harder

Design for success. Then the point of failure will become obvious

Lean – Before and After Example

HQ PARC sends formal approval of plan

Revised final plan sent to PARC for Sig

PARC AO prepares approval memo

HQ reviews plan

HQ distributes plan for review

District submits revised plan

District resolves cmts

HQ sends cmts to MSC

HQ reviews plan

RIT distributes plan for review

HQ distributs plan for review

HQ logs In plan reciept

MSC/DoCreviews and sends to HQ

District sends revised draft to MSC


MSC sends cmts to District

MSC reviews draft

AcqPlan Distributed in MSC

Staff for Signature/Send to MSC

Resolve Cmtsand Finalize

Staff Draft within District

Resolve KO Cmts/Finalize Draft

Staff Plan to KO/PA

Draft Initial AcqPlan

Finalize AcqStrategy

Conduct Market Research

Determine that formal ACQ Plan is required

272625242322212019181716151413121110987654321

Current Process

HQ PARC sends formal approval of plan

Revised final plan sent to PARC for Sig

PARC AO prepares approval memo

HQ reviews plan

HQ distributes plan for review

District submits revised plan


HQ sends cmts to MSC

HQ reviews plan

RIT distributes plan for review

HQ distributs plan for review

HQ logs In plan reciept

MSC/DoCreviews and sends to HQ

District sends revised draft to MSC


MSC sends cmts to District

MSC reviews draft

AcqPlan Distributed in MSC

Staff for Signature/Send to MSC

Resolve Cmtsand Finalize

Staff Draft within District

Resolve KO Cmts/Finalize Draft

Staff Plan to KO/PA

Draft Initial AcqPlan

Finalize AcqStrategy

Conduct Market Research

Determine that formal ACQ Plan is required

272625242322212019181716151413121110987654321

Current Process Before – 27 Steps

After- 5 Steps

Value Stream Analysis Template

Lean – Value Stream Analysis

Value Stream Analysis Results

CurrentProcess

FutureProcess

ImprovementPossible

Steps 27 5 82%

Cycle Time (min) 20 5 75%

Touch Time (day) 5 1 80%

# of People 10 2 80%

Approvals 4 1 75%

Rework 70% 10% 85%

What to look for during process design Where do errors occur (errors cause

defects) Where does rework or redo loop steps often

appear? Wait time between steps or lost time in the

process / dead zones Unused outputs or pointless work Redundant / duplicate activities Inefficient movement of work between

process steps Inspections where a Poka-Yoke (automated

mistake proofing) would work better Bottlenecks in the process Excessive hand-offs in the process Excessive approvals built into the process Steps marked as “rush”

Processes that are experiencing excessive OT

Lack of or too much required documentation Is the fix or a solution planned in an

upcoming system change? Are there policies that need to be enforced? Do we need new policies? Is there a vendor who could perform these

steps for us? Do new features or functionalities need to

be added?

What to look for - continued

Errors due to a misunderstanding of the process

Errors due to inability to identify something correctly

Errors made by untrained personnel Errors due to someone ignoring the

process Errors due to lack of standards or

procedures

Human Errors / Issues to Watch For

Can the step be eliminated? Can the step be combined with another step? Can the step be reduced in some way? Can we eliminate inspections within the step? Can we eliminate approvals within the step? Should we slow down the step? Can we use fewer resources to complete the

step? Can we reduce wait time within the step? Can we ID an error in an automated way in the

step? Can we reduce the number of errors we make? Can we reduce hand-offs within the step?

Lean Questions to Remove Waste

Value Stream Analysis (VSA) Project

Defined the process to improve Tied to Strategic Plan (High Performance Organization)

Lean Facilitator Facilitation skills essential

Management Support Process Owner is the person who will sign off on changes This person MUST be on board

Charter Defines requirements, scope, expectations BEFORE you

start

Team Every step of the process must be covered Customers or stakeholders should participate or be

consulted This is where you achieve buy-in

Our Lean Process Tool Box

Synergies Between BPE and Lean 6σ• Provides a Broad Spectrum of Methods

Available for PI Initiatives• Lean 6σ Projects Feed Development of EBPM• Lean 6σ Provide “In the Trenches” Micro View

of Current Business Processes• EBPM and BPE Provide Macro View of Current

Business Processes• Promote Direct Action to Improve Critical

Areas of the Business• Promote Understanding and “Ground Truth”

About the Business Strengths and Weaknesses• Promote Learning and Knowledge Sharing• Promote a Common Language Within the

Organization

Lessons Learned• Management Support / Sponsorship is

Required Irrespective of the Level of Engagement

• Define Your Process Measurements – Simple and Relevant

• Find Allies in the Business – You Can’t Do It Alone

• Technology is Your Friend – Build Bridges to IT • Start Small With Focused Pilots – Don’t Try to

“Boil the Ocean”• Use Appropriate Methods and Tools for Specific

Problems• Not All Managers and Employees Will “Get It”

– Right Project, Right People at the Right Time• Stay Positive and Focus on Gains – Setbacks

Will Happen

Contact Information

Blue Cross and BlueShield of Nebraska

7261 Mercy Road South Bldg, 3rd Floor

Omaha, NE 68180

www.bcbsne.com

Bob Tippett, BBWork =

[email protected]

Rich Rozgay, MBBWork =

[email protected]

m