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?