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NOTICE: PROPRIETARY AND CONFIDENTIAL
This material is proprietary to and contains trade secrets and information which is solely the property of Centric Consulting, LLC. It is solely for the Client’s internal use and shall not be used,
reproduced, copied, disclosed, transmitted, in whole or in part, without the express consent of Centric Consulting, LLC. © 2016 Centric Consulting, LLC. All rights reserved.
Effective Scoping and Execution of Business Process
Efforts in Major System Implementations
Presented by: Mark Buchynski
TABLE OF CONTENTS
2
+ APQC’s Process
Classification
Framework
+ Start with a
Process Inventory
+ Degree of Process
Work Desired or
Required
+ Level of Effort
Estimation
Framework
+ Start with Vendor
Application Flows
+ Be Aware of and
Work Within
System
Constraints
+ Collaboratively
Define the “To-Be”
Wrapper Process
+ Ensure to Build-In
Improvements
Over Current State
+ Identify Required
Effort Up-Front
+ Develop Common
Understanding of
Detailed Future
State Process
+ Provide a
Foundation for
Training
+ Enable
Standardization
and Adoption
+ Background for
our Story
+ Trouble with
Mixed
Expectations
+ Painful
Forecasting
Implications
Importance of
BP Scoping
Tools to Aid in
Scoping
BP for
Systems
Delivering
Results
01 02 03 04INTRO
Pages 24–26Pages 19–23Pages 11–18Pages 6–10Pages 3–5
WHO WE ARE
We’re a business consulting and technology solutions company that’s been
around for more than 15 years and we’re building a company that will be here for
100 more.
3
”99: Year
Founded
750+
Consultants
13 Locations 32+ Practice Areas
Business Consulting,
Technology Solutions,
Industry Areas, Digital
106 Million USD
(2015 revenue)
Boston; Charlotte;
Chicago; Cincinnati–
Dayton; Cleveland,
Columbus; Indianapolis;
Louisville; Miami;
Seattle; St Louis;
Tampa; Gurgaon, India
BOLD VISION
to span
100 years
Full Lifecycle Capabilities
Marketing Operations
Enable & Sustain
Change
WHAT WE DO
We are passionate about the intersection of business and technology. A blend of skills
that result in solid execution and a partner with a wide range of capabilities.
4
INDUSTRY EXPERTISE
Energy and Utilities
Financial Services
Government
Healthcare
Insurance
Logistics /Supply Chain
Manufacturing/Products
Retail
Travel
Improve Performance via
Process Excellence
Digital Technologies
Specialized Expertise
DIGITAL
BUSINESS
CONSULTING
TECHNOLOGY
SOLUTIONS
Tools & Technologies
Transform & Grow
Your Business
Interactive
Digital Strategy
Importance of BP Scoping
Why scoping of business process efforts in system
implementations should be important to you
BACKGROUND STORY
Our Client’s original level of
effort and budget estimate for
Business Process support
related to their Policy Admin
System (PAS) Implementation
was off by 8.5+ times.
Due to solid results in streamlining the
Client Onboarding process within a sister
division within our client, the EPMO
Director and the Division Business
Process lead engaged Centric to support
the PAS implementation.
Client was engaged in a multi-year, multi-
million dollar implementation spanning
most core functional areas.
Centric quickly focused our efforts on a
scoping and estimation exercise which
yielded some shocking realities.
Though our analysis pointed to needing
more resources, our Client was relatively
slow to take action and add more
resources and adjust the project plan.
In Jan of ‘14
brought in to
provide 1 FTE
(Katie) for 6
months to define
all future state
processes
Created process
inventory,
determined degree
of process work
required and
estimated level of
effort to deliver.
Have provided up
to 3 business
process support
resources over 3+
years.
1 2 3
Evolution of our Business
Process Journey with our
voluntary benefits insurance
provider Client :
6
CLIENT’S INITIAL VIEW
Initial High-Level Process Inventory
Initial estimation efforts were very high-level, with limited estimation experience
7
● High-level assessment of
process areas impacted by
system implementation
completed
● High-level top-down estimate of
business process design effort
compiled with limited experience
● Drill down into level of process
design required at the sub-
process and work-flow levels not
initially completed
● Work effort estimation was a
swag at best
Scoping Approach
Client identified 5 processes heavily
impacted along with 3 areas
impacted to a smaller degree
CENTRIC ASSESSMENT
Centric Inventory & Estimation
Detailed process inventory and work-effort estimation yielded a bit of a shock!
8
● Created a process inventory and drilled into an
additional 3 levels of detail:
o Level 2: Process group
o Level 3: Process
o Level 4: Activity
● Focused on processes (L3) and activities (L4)
that would be most significantly impacted by
PAS implementation
● Validated level of detail required to drive training
and procedure documentation of new standard
processes – e.g., Level 4 (activity) & 5 (task)
process documentation
● Conducted bottom-up estimate of level of effort
required by process (L3)
Scoping Approach
20 sub-processes with 80 Activities to be
redesigned: Initial Estimates > 4K-5K hours
WHERE ARE WE TODAY?
Process design has taken significantly longer and required more effort than planned
9
●Cost – the Program Team originally
planned for $200K in business
process design work. Through mid
2017 the revised plan is > $1.5M!!
●Team – plan was to utilize one full
time Business Process consultant.
We have had up to 3 full time
process consultants during peak
demand.
●Duration – Original plan was to
complete process work in 6 to 9
months; Per the revised plan
business process design support will
be required for 3+ years
Forecasting Overrun
Top-down “swags” on the front-end
of significant system
implementations can cause painful
true-ups over the life of a program!
HOWEVER…
The organization is driving standardization and adoption of a major transformation
10
●Engagement & Buy-in
– Involving the impacted parties and
collaborating on the detail future state
process design enhances ability to
standardize
Standards Adoption
●Foundation for Training
– Doing the required detailed
business process design was
leveraged to accelerate the creation of
standard operating procedures and
training material
Tools to Aid in Scoping
How APQC’s Process Classification Framework (PCF) can aid
your business process scoping efforts
SCOPING PROCESS OVERVIEW
Inventory relevant processes and estimate required effort to define future state design
●PCF – Leverage a framework such as
APQC’s process classification framework
to establish a common syntax for defining
or indexing enterprise processes
● Catalog – List processes impacted and
degree of impact
Process Inventory
●Required Detail – Determine level of
process design required across inventory
●Define Approach – Adapt process
design approach for your environment
●Estimate Effort – Estimate hours of
process design support anticipated
To-Be Design Estimation
12
APQC’s PCF – WHAT IS IT?
American Productivity and Quality Center – Standards Body for Enterprise Processes
Process Classification
Framework (PCF)
Benefits of Framework
●Provides a standard model of business
and organization that supports process
analysis and design activities
●Ensures we have properly defined
borders (scope) of process-based
initiatives
●Helps drive a common process
language
●Ensures we have worked through
complete business process (internal
and customer)
●Allows us to better understand the level
of detail required for process analysis
and development
13
APQC’s PCF – DETAIL LEVELS
Provides guidance and standards on differing levels of detail. Helps companies
contemplate what level is needed for what purpose.
14
APQC’s PCF – CLOSER LOOK
Inventory relevant processes and estimate required effort to define future state design
15
PROCESS INVENTORY
Step 1: Translating from the high-level process areas to a detail list based on the PCF
Step 2: Summarize # of process areas impacted, complexity of processes and level of
process impact
16
EFFORT ESTIMATION
Step 3: Define required activities (approach) for process redesign and estimate effort
per business process at the activity level
17
CAPACITY PLANNING
18
0
200
400
600
800
1000
1200
1400
1600
1Q16 2Q16 3Q16 4Q16 1Q17 2Q17 3Q17 4Q17
TotalHours
Process Lead Process Rsrc 1 Process Rsrc 2
Quarterly Process
Team Hours
28
12
24
15
142
57
96
64
0 20 40 60 80 100 120 140 160 180
Track 4
Track 3
Track 2
Common + Track 1
Total Processes Total Activities
Processes +
Activities by Track
BP For Systems
How business process work in the context of systems
implementations is different
APPROACH OVERVIEW
Business process design work for system implementations needs to factor in the
constraints or guard-rails of the technical solution
BUSINESS
PROCESS
DESIGN
Start With System Work-
Flows
Understand the typical human system
interactions for the system as a starting
point. Need to work with your solution
vendor to obtain system documentation
on work-flows as configured for your
business.
Translate BP into SOP’s and
Training Materials
Identify business processes that will be
impacted most by the new system
solution and detail the to-be design
down to the task level (L5). Detailed
process documentation serves as an
accelerator for SOP’s and training
content.
Understand Current State
Seek to quickly document the current
state as it pertains to the existing
technology solution along with the
complementary business process.
Understand key pain-points and
opportunities for improvement.
Define To-Be “Wrapper”
Process
Collaboratively engage with the
business/users to envision and iterate
on the optimal new business process
that surrounds the core system work-
flows resulting from the solution
configuration.
20
APPLICATION FLOWS
System work flows serve as the guard rails and starting point
Availability, and relevance of system work-
flow documentation needs to be factored
into your overall process re-design plans.
Missing this puzzle piece can delay your
ability to start on redesigning a business
process.
Considerations
●Validate documentation - ensure that
adequate system or application work-flow
documentation exists and is available when
you start your design work
o Engage vendors early on about availability
of this documentation
●If documentation does not exist you may
need to plan for alternate means of defining
these critical work-flows
●Avoid customizations - to systems flows;
work to adapt to “out-of-the box”
configurations
●Don’t lose sight of the broader process -
applications flows are only a part of the
overall business process
21
BROADER BUSINESS PROCESS
Define the business process that surrounds the applications flows – ensure that it is
optimized for the new environment
Considerations
●Avoid Paving the Cow Path – Understand
current pain points and inefficiencies and
seek to design-in process improvements
●Collaborate and Iterate – Engage with
impacted parties and collaborate with them
on the future design to drive buy-in. Plan
for multiple iterations to challenge and
optimize the status quo.
o Ensure you plan for process re-factoring
with future system releases
Challenge the status quo, but be aware of
working within the constraints of your
system work-flows – maintain the
balancing act.
Avoid the illusion of “blue-sky”
transformation
22
FOUNDATION FOR TRAINING
Detailed process flows and SIPOC diagrams capture future-state details at a level
appropriate to drive standard operating procedures and training
Considerations
●Process Flow Diagrams – overall business
processes need to be documented as a
sufficient level of detail (L4/L5) to define
standard work-flows to the stakeholders
involved
●S.I.P.O.C. Diagrams – these artifacts
capture critical details about the process
that cannot be effectively depicted in the
process documents
o Actors involved in the process
o Key inputs/outputs: tools, artifacts required
4.3 Adjudicate Claims – Accident
ClaimsAdminSystem
4.3.3 Process intake of claims
4.3.3.1a Enter claim into claims system
4.3.3.6 Assign claim ID
4.3.3.5b Create claims
record within claims
system
4.3.5.4 Notify claimant of insufficient
proofs
4.3.3.7b Route claim for processing
Inputs:
· Notice of loss from
claimant (via phone,
mail, fax or email)
· Email from Claims Rep
handling a claim on a
different policy that an
additional claim should
be registered
4.3.3.1.6
Select insured
person
4.3.3.1.1
Receive
notification of
claim
4.3.3.1.2
Look up policy in
Claim Registration
screen
4.3.3.1.4
Can a
previously
opened claim
on the same
policy be used?
4.3.3.1.5
Complete Claim
Details section
4.3.3.1.8
Access the prior
claim
Yes
May search by
SSN, policy #, or
name
No
4.3.3.1.9
Any portion of
claim proof(s)
received?
4.3.3.1.10
Change claim
status to P01
status (Pending
Claim status)
4.3.3.1.11
Update claim
incurred date, if
known
Yes
4.3.3.6.1
InsPro
assigns claim
number
Covered
Person
Records from
InsPro Admin
4.3.3.1.7
Process
registration In
InsPro
InsPro
populates
Registration
screen with
insured/policy
details
Policy Details:
Insured(s)
Status
Insureds
Coverages
4.3.3.5b.1
InsPro builds
claim abstract
(P02 status)
Any portion of
claim proof(s)
received?
END
4.3.5.4.1
Select
acknowledgement
letter and Initial
Claim Form (ICF)
4.3.5.4.2
Change claim
status to Closed
No
4.3.3.7b.2
Assign claim to
Claim Rep
4.3.2.4b
Determine
eligibility
· Available coverages
and required proofs
populated as abstract
is built
· P02 status = Pending
initial notification
4.3.3.1.3
Check for any prior
claims
Check “# of health
claims” field
4.3.3.7b.1
Access pending
claim queue
Yes
No
Select “OK &
Open Claim”
Includes:
· Health Claim Type
· Claim received
date
· Claim incurred
date (if available)
L3
L4
L5
There is work needed to take these documents and
make them digestible as SOP’s and training content
23
Delivering Results
What an effective business process scoping and execution effort
can deliver for your organization
VALUE OF APPROACH
25
Up Front Estimation
Avoid painful budgetary and or
schedule surprises for your
implementation program. Understand
what you are getting into before you
start.
Alignment on Future State
Engage with key stakeholders
throughout the future-state design
process to generate ownership and
buy-in to future direction. Leverage
the solution’s existing workflows.
Foundation for Training
Accelerate development of standard
operating procedures and training
content by capturing details early in
design effort.
TAKE-AWAYS
26
●Plan for Multiple Iterations – Factor
in multiple iterations of process design
work depending on where the project is
regarding design and testing
●Consider Testing – Consider and plan
for how to test the processes in
conjunction with the system
● Process Governance – Develop and
implement a practical and sustainable
process governance/maintenance plan;
you've made a significant investment,
now preserve it!
QUESTIONS?
Contact Centric
27
To learn more about Centric Consulting Solutions:
CentricConsulting.com
Mark Buchynski – Director Business Consulting Services
Email: mark.buchynski@centricconsulting.om
Phone: 847.867.8454

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Effective scoping and execution of business process efforts in major system implementations

  • 1. NOTICE: PROPRIETARY AND CONFIDENTIAL This material is proprietary to and contains trade secrets and information which is solely the property of Centric Consulting, LLC. It is solely for the Client’s internal use and shall not be used, reproduced, copied, disclosed, transmitted, in whole or in part, without the express consent of Centric Consulting, LLC. © 2016 Centric Consulting, LLC. All rights reserved. Effective Scoping and Execution of Business Process Efforts in Major System Implementations Presented by: Mark Buchynski
  • 2. TABLE OF CONTENTS 2 + APQC’s Process Classification Framework + Start with a Process Inventory + Degree of Process Work Desired or Required + Level of Effort Estimation Framework + Start with Vendor Application Flows + Be Aware of and Work Within System Constraints + Collaboratively Define the “To-Be” Wrapper Process + Ensure to Build-In Improvements Over Current State + Identify Required Effort Up-Front + Develop Common Understanding of Detailed Future State Process + Provide a Foundation for Training + Enable Standardization and Adoption + Background for our Story + Trouble with Mixed Expectations + Painful Forecasting Implications Importance of BP Scoping Tools to Aid in Scoping BP for Systems Delivering Results 01 02 03 04INTRO Pages 24–26Pages 19–23Pages 11–18Pages 6–10Pages 3–5
  • 3. WHO WE ARE We’re a business consulting and technology solutions company that’s been around for more than 15 years and we’re building a company that will be here for 100 more. 3 ”99: Year Founded 750+ Consultants 13 Locations 32+ Practice Areas Business Consulting, Technology Solutions, Industry Areas, Digital 106 Million USD (2015 revenue) Boston; Charlotte; Chicago; Cincinnati– Dayton; Cleveland, Columbus; Indianapolis; Louisville; Miami; Seattle; St Louis; Tampa; Gurgaon, India BOLD VISION to span 100 years
  • 4. Full Lifecycle Capabilities Marketing Operations Enable & Sustain Change WHAT WE DO We are passionate about the intersection of business and technology. A blend of skills that result in solid execution and a partner with a wide range of capabilities. 4 INDUSTRY EXPERTISE Energy and Utilities Financial Services Government Healthcare Insurance Logistics /Supply Chain Manufacturing/Products Retail Travel Improve Performance via Process Excellence Digital Technologies Specialized Expertise DIGITAL BUSINESS CONSULTING TECHNOLOGY SOLUTIONS Tools & Technologies Transform & Grow Your Business Interactive Digital Strategy
  • 5. Importance of BP Scoping Why scoping of business process efforts in system implementations should be important to you
  • 6. BACKGROUND STORY Our Client’s original level of effort and budget estimate for Business Process support related to their Policy Admin System (PAS) Implementation was off by 8.5+ times. Due to solid results in streamlining the Client Onboarding process within a sister division within our client, the EPMO Director and the Division Business Process lead engaged Centric to support the PAS implementation. Client was engaged in a multi-year, multi- million dollar implementation spanning most core functional areas. Centric quickly focused our efforts on a scoping and estimation exercise which yielded some shocking realities. Though our analysis pointed to needing more resources, our Client was relatively slow to take action and add more resources and adjust the project plan. In Jan of ‘14 brought in to provide 1 FTE (Katie) for 6 months to define all future state processes Created process inventory, determined degree of process work required and estimated level of effort to deliver. Have provided up to 3 business process support resources over 3+ years. 1 2 3 Evolution of our Business Process Journey with our voluntary benefits insurance provider Client : 6
  • 7. CLIENT’S INITIAL VIEW Initial High-Level Process Inventory Initial estimation efforts were very high-level, with limited estimation experience 7 ● High-level assessment of process areas impacted by system implementation completed ● High-level top-down estimate of business process design effort compiled with limited experience ● Drill down into level of process design required at the sub- process and work-flow levels not initially completed ● Work effort estimation was a swag at best Scoping Approach Client identified 5 processes heavily impacted along with 3 areas impacted to a smaller degree
  • 8. CENTRIC ASSESSMENT Centric Inventory & Estimation Detailed process inventory and work-effort estimation yielded a bit of a shock! 8 ● Created a process inventory and drilled into an additional 3 levels of detail: o Level 2: Process group o Level 3: Process o Level 4: Activity ● Focused on processes (L3) and activities (L4) that would be most significantly impacted by PAS implementation ● Validated level of detail required to drive training and procedure documentation of new standard processes – e.g., Level 4 (activity) & 5 (task) process documentation ● Conducted bottom-up estimate of level of effort required by process (L3) Scoping Approach 20 sub-processes with 80 Activities to be redesigned: Initial Estimates > 4K-5K hours
  • 9. WHERE ARE WE TODAY? Process design has taken significantly longer and required more effort than planned 9 ●Cost – the Program Team originally planned for $200K in business process design work. Through mid 2017 the revised plan is > $1.5M!! ●Team – plan was to utilize one full time Business Process consultant. We have had up to 3 full time process consultants during peak demand. ●Duration – Original plan was to complete process work in 6 to 9 months; Per the revised plan business process design support will be required for 3+ years Forecasting Overrun Top-down “swags” on the front-end of significant system implementations can cause painful true-ups over the life of a program!
  • 10. HOWEVER… The organization is driving standardization and adoption of a major transformation 10 ●Engagement & Buy-in – Involving the impacted parties and collaborating on the detail future state process design enhances ability to standardize Standards Adoption ●Foundation for Training – Doing the required detailed business process design was leveraged to accelerate the creation of standard operating procedures and training material
  • 11. Tools to Aid in Scoping How APQC’s Process Classification Framework (PCF) can aid your business process scoping efforts
  • 12. SCOPING PROCESS OVERVIEW Inventory relevant processes and estimate required effort to define future state design ●PCF – Leverage a framework such as APQC’s process classification framework to establish a common syntax for defining or indexing enterprise processes ● Catalog – List processes impacted and degree of impact Process Inventory ●Required Detail – Determine level of process design required across inventory ●Define Approach – Adapt process design approach for your environment ●Estimate Effort – Estimate hours of process design support anticipated To-Be Design Estimation 12
  • 13. APQC’s PCF – WHAT IS IT? American Productivity and Quality Center – Standards Body for Enterprise Processes Process Classification Framework (PCF) Benefits of Framework ●Provides a standard model of business and organization that supports process analysis and design activities ●Ensures we have properly defined borders (scope) of process-based initiatives ●Helps drive a common process language ●Ensures we have worked through complete business process (internal and customer) ●Allows us to better understand the level of detail required for process analysis and development 13
  • 14. APQC’s PCF – DETAIL LEVELS Provides guidance and standards on differing levels of detail. Helps companies contemplate what level is needed for what purpose. 14
  • 15. APQC’s PCF – CLOSER LOOK Inventory relevant processes and estimate required effort to define future state design 15
  • 16. PROCESS INVENTORY Step 1: Translating from the high-level process areas to a detail list based on the PCF Step 2: Summarize # of process areas impacted, complexity of processes and level of process impact 16
  • 17. EFFORT ESTIMATION Step 3: Define required activities (approach) for process redesign and estimate effort per business process at the activity level 17
  • 18. CAPACITY PLANNING 18 0 200 400 600 800 1000 1200 1400 1600 1Q16 2Q16 3Q16 4Q16 1Q17 2Q17 3Q17 4Q17 TotalHours Process Lead Process Rsrc 1 Process Rsrc 2 Quarterly Process Team Hours 28 12 24 15 142 57 96 64 0 20 40 60 80 100 120 140 160 180 Track 4 Track 3 Track 2 Common + Track 1 Total Processes Total Activities Processes + Activities by Track
  • 19. BP For Systems How business process work in the context of systems implementations is different
  • 20. APPROACH OVERVIEW Business process design work for system implementations needs to factor in the constraints or guard-rails of the technical solution BUSINESS PROCESS DESIGN Start With System Work- Flows Understand the typical human system interactions for the system as a starting point. Need to work with your solution vendor to obtain system documentation on work-flows as configured for your business. Translate BP into SOP’s and Training Materials Identify business processes that will be impacted most by the new system solution and detail the to-be design down to the task level (L5). Detailed process documentation serves as an accelerator for SOP’s and training content. Understand Current State Seek to quickly document the current state as it pertains to the existing technology solution along with the complementary business process. Understand key pain-points and opportunities for improvement. Define To-Be “Wrapper” Process Collaboratively engage with the business/users to envision and iterate on the optimal new business process that surrounds the core system work- flows resulting from the solution configuration. 20
  • 21. APPLICATION FLOWS System work flows serve as the guard rails and starting point Availability, and relevance of system work- flow documentation needs to be factored into your overall process re-design plans. Missing this puzzle piece can delay your ability to start on redesigning a business process. Considerations ●Validate documentation - ensure that adequate system or application work-flow documentation exists and is available when you start your design work o Engage vendors early on about availability of this documentation ●If documentation does not exist you may need to plan for alternate means of defining these critical work-flows ●Avoid customizations - to systems flows; work to adapt to “out-of-the box” configurations ●Don’t lose sight of the broader process - applications flows are only a part of the overall business process 21
  • 22. BROADER BUSINESS PROCESS Define the business process that surrounds the applications flows – ensure that it is optimized for the new environment Considerations ●Avoid Paving the Cow Path – Understand current pain points and inefficiencies and seek to design-in process improvements ●Collaborate and Iterate – Engage with impacted parties and collaborate with them on the future design to drive buy-in. Plan for multiple iterations to challenge and optimize the status quo. o Ensure you plan for process re-factoring with future system releases Challenge the status quo, but be aware of working within the constraints of your system work-flows – maintain the balancing act. Avoid the illusion of “blue-sky” transformation 22
  • 23. FOUNDATION FOR TRAINING Detailed process flows and SIPOC diagrams capture future-state details at a level appropriate to drive standard operating procedures and training Considerations ●Process Flow Diagrams – overall business processes need to be documented as a sufficient level of detail (L4/L5) to define standard work-flows to the stakeholders involved ●S.I.P.O.C. Diagrams – these artifacts capture critical details about the process that cannot be effectively depicted in the process documents o Actors involved in the process o Key inputs/outputs: tools, artifacts required 4.3 Adjudicate Claims – Accident ClaimsAdminSystem 4.3.3 Process intake of claims 4.3.3.1a Enter claim into claims system 4.3.3.6 Assign claim ID 4.3.3.5b Create claims record within claims system 4.3.5.4 Notify claimant of insufficient proofs 4.3.3.7b Route claim for processing Inputs: · Notice of loss from claimant (via phone, mail, fax or email) · Email from Claims Rep handling a claim on a different policy that an additional claim should be registered 4.3.3.1.6 Select insured person 4.3.3.1.1 Receive notification of claim 4.3.3.1.2 Look up policy in Claim Registration screen 4.3.3.1.4 Can a previously opened claim on the same policy be used? 4.3.3.1.5 Complete Claim Details section 4.3.3.1.8 Access the prior claim Yes May search by SSN, policy #, or name No 4.3.3.1.9 Any portion of claim proof(s) received? 4.3.3.1.10 Change claim status to P01 status (Pending Claim status) 4.3.3.1.11 Update claim incurred date, if known Yes 4.3.3.6.1 InsPro assigns claim number Covered Person Records from InsPro Admin 4.3.3.1.7 Process registration In InsPro InsPro populates Registration screen with insured/policy details Policy Details: Insured(s) Status Insureds Coverages 4.3.3.5b.1 InsPro builds claim abstract (P02 status) Any portion of claim proof(s) received? END 4.3.5.4.1 Select acknowledgement letter and Initial Claim Form (ICF) 4.3.5.4.2 Change claim status to Closed No 4.3.3.7b.2 Assign claim to Claim Rep 4.3.2.4b Determine eligibility · Available coverages and required proofs populated as abstract is built · P02 status = Pending initial notification 4.3.3.1.3 Check for any prior claims Check “# of health claims” field 4.3.3.7b.1 Access pending claim queue Yes No Select “OK & Open Claim” Includes: · Health Claim Type · Claim received date · Claim incurred date (if available) L3 L4 L5 There is work needed to take these documents and make them digestible as SOP’s and training content 23
  • 24. Delivering Results What an effective business process scoping and execution effort can deliver for your organization
  • 25. VALUE OF APPROACH 25 Up Front Estimation Avoid painful budgetary and or schedule surprises for your implementation program. Understand what you are getting into before you start. Alignment on Future State Engage with key stakeholders throughout the future-state design process to generate ownership and buy-in to future direction. Leverage the solution’s existing workflows. Foundation for Training Accelerate development of standard operating procedures and training content by capturing details early in design effort.
  • 26. TAKE-AWAYS 26 ●Plan for Multiple Iterations – Factor in multiple iterations of process design work depending on where the project is regarding design and testing ●Consider Testing – Consider and plan for how to test the processes in conjunction with the system ● Process Governance – Develop and implement a practical and sustainable process governance/maintenance plan; you've made a significant investment, now preserve it!
  • 27. QUESTIONS? Contact Centric 27 To learn more about Centric Consulting Solutions: CentricConsulting.com Mark Buchynski – Director Business Consulting Services Email: mark.buchynski@centricconsulting.om Phone: 847.867.8454