A case in point is Employee Benefit Management Corp. (EBMC), with
headquarters in Dublin, Ohio. As a third-party administrator of
employee benefit programs, EBMC designs, manages and services
self-funded medical, dental, vision, prescription drug, and short-term
disability programs for employers and their employees. The high volume
of reports that EBMC produces for each client company shows how the
plans are operating and the amount of claims paid to plan participants.
Having timely reports both daily and at month's end, is critical to the
bottom line for EBMC's clients because they are responsible for funding
participants' claims.
EBMC's problem wasn't the data collection itself. This
processing was being done by its Unix-based RIMS claim administration
software, running at EBMC on an HP9000, Model K460, Enterprise Server.
Rather, the problem came from how the reports were being exported and
routed or distributed to client companies. EBMC's report distribution
process was entirely paper-based and both EBMC and their clients were
drowning in paper every month.
Relying on manual processes to sort reports was one area of
concern for EBMC's managers. Relying on the postal system and faxing
for distribution to clients was another because it made EBMC's reports
prone to delay. At the same time, many of the company's clients saw
wholesale improvements that advanced supply chain packages were making
to connect business enterprises with customers, prompting their
encouragement of EBMC's investigation into updating and automating the
reporting process.
Traditional methods of printing and manually bursting the
monthly reports required upwards of 20 hours and produced a total of
9,500 paper pages for distribution to 80 clients, some of whom needed
multiple copies of reports sent to more than one address. On a daily
basis, funding notifications were faxed to nearly 50 clients. This job
alone required one employee to stand at a fax machine for nearly half
the day, every day. All of this illustrates the kinds of pragmatic
reporting and distribution issues IT groups historically face.
EBMC achieved higher levels of customer service and paperless
reporting by using a solution from Hillary Software that automates
several stages of report processing and distribution via the Internet.
The company trimmed job cycles that took half a day to run to just 10
minutes.
Beyond reporting and distribution, other inefficiencies
surfaced as the Information Services (IS) group studied the situation.
Some of these stemmed from archiving paper-based data. A microfiche
machine allowed EBMC account managers access to the previous month's
client reports, but these had to be printed before the account manager
could respond to a client's information request.
By looking at customer requirements, the group soon had a clear
picture of a number of areas in need of change. A critical priority was
a system that would work in concert with the Resource Information
Management Systems (RIMS) claims administration system to
electronically produce segmented, customized output in PC desktop file
formats for each report, and then send these via e-mail to each client.
EBMC first considered internally developing scripts and
templates for bursting of the various monthly reports. However, each
report would have required a different process because the key to
accurate bursting varied by report. Additionally, the network
connection and transfer of these reports to a PC environment, as well
as the delivery process, had to be automated.
A simple solution
After numerous inquires about the efficiency and benefits of
electronic reporting from existing and potential new clients, the IS
group investigated different solutions. The first step was to identify
client needs. Corporate benefit program managers, for example, wanted
to know if stages such as enrollment could be accomplished better
online, replacing the use of multipart forms. Was it feasible to
achieve similar streamlining in the production and distribution of the
reports used by benefits administrators and HR managers while also
maintaining accurate controls an fiduciary responsibility over their
company benefit programs?
Even with known client interest, the IS group had no guarantee
any solution would win over clients. A solution also had to win friends
among EBMC company users who wanted a highly functional, automated
system. Moreover the IS group needed a manageable, straightforward
implementation, equating to minimizing the risk and the cost of change.
One solution that satisfied all of these various requirements
associated with report distribution was byREQUEST, a software
application from Hillary Software.
EBMC had favored a PC-based solution during its evaluations in
order to facilitate both deployment by the IS group and the day-to-day
operation by company staff. Early use of byREQUEST, clearly showed how
the off-the-shelf application could free the IS group from the need for
individual scripting for clients' reports and supporting changes while
it allowed the group to concentrate on core business requirements. The
application also enabled EBMC to generate numerous ODBC compliant
standard reports using the RIMS database.
EBMC took the plunge in November 1999, becoming a beta test
site for byREQUEST on an HP9000 K460 server. The most time-consuming
aspect of setup for the company's transformation was gathering e-mail
addresses from those clients wishing to receive their reports via
e-mail. To get the ball rolling, EBMC sent out request forms with the
December reports. Just one month later, EBMC was sending out its first
electronically segmented and delivered reports.
Electronic bursting of reports coming from the company's Unix
based database into PC-formatted reports greatly enhanced overall data
availability and usability. Improved information delivery to both
clients and internal EBMC personnel was the bottom line result. Planned
as well as unforeseen improvements in efficiencies were immediate and
dramatic!
EBMC staff uses byREQUEST to browse the Unix spooler and choose
the desired report format. These may be Microsoft Word, Excel, PDF or
any of a number of industry standard PC formatting options. Users find
the application enables them to interface with data from the Unix
server. Data can be viewed, formatted, printed, sectioned, burst and
archived, all from a PC or NT Server. This is accomplished without
imposing on the IS group for installing or maintaining client software.
Companies interested in making their reporting processes highly
automated should also note that this system, when used on a PC with
mail services, will also automatically e-mail reports to designated
addresses. This is important because it enables users to place reports
on internal, shared network drives with PC desktop extensions such as
.DOC, .XLS, .PDF and .HTM. Today, EBMC's users are saving significant
amounts of time because they can simply double-click and go on, for
example, to provide other customer services.
Interestingly, during the early transition stage with clients,
EBMC agreed to fax daily reports in parallel. This transitionary
measure was intended to allow clients to become accustomed to receiving
and working with files electronically. Yet, after only a few days, most
users called asking to stop the faxes-validating almost overnight the
decision to go "paperless" and receive reports electronically.
Timely data delivery
No longer are monthly reports being received mid-month. Clients
now receive reports no later than the fifth of each month. Also
drastically improved was the delivery of daily reports, which include
funding notifications that advise clients of benefit checks issued each
day and the amount of funds needed to cover these checks. With
electronic report bursting and delivery, a half-day job was reduced to
10 minutes. Of course, speed isn't everything. "We were concentrating on
trying to deliver data faster to our clients so that they could more
effectively manage their health benefit plans," Lori Richard, EBMC
account manager, said. "However, one of the asides that came out of
implementing the software was that our clients are now able to
streamline the electronic data we provide which they can feed into
their own financial systems. This enables them to become more efficient
through the elimination of data entry." Because the reports are
electronic when they arrive, the data is easily imported into low cost
PC analysis tools users can use and understand immediately.
In terms of streamlined efficiencies, the same is true for
EBMC. "Another positive is that we now have all of the reports posted
on a shared server internally, so that if an account manager needs to
know what a client's expenditures were for January 2000, they can sit
at their desk and pull it up," Richard says. "No more microfiche." The
easy access provided by the shared server ultimately allows for greatly
improved customer service.
Underpinnings of the future
Initial worries about client buy-in proved unnecessary for EBMC.
Once a funding notification, for example, was made available via
e-mail, the company had 99 percent client involvement within two weeks.
Only one of the 48 companies notified chose to continue to be faxed;
the contact person at that client site doesn't currently have e-mail
capability. More than half of those clients receiving monthly reports
now get them via e-mail. Those companies that continue to get the
reports in print also benefit because the overall process is faster.
Based on these results with clients, EBMC is committed to a far
faster electronic, less paper-filled world. The company is internally
developing a solution to provide online enrollment. The new level of
management reporting capability will prove especially timely as EBMC's
clients are tasked with meeting the latest requirements of the
Healthcare Insurance Portability and Accountability Act (HIPAA).
Industry experts predict that HIPAA will bring changes more sweeping
than Medicare to EBMC and independent plan providers.
Recent updates to byREQUEST such as automated faxing and
electronic FORMS support are under consideration for future
implementation.
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