WebSphere Business Monitor

Success stories

Healthcare Industry: Correspondence Imaging

Health insurance provider to save estimated $15 million over three years with IBM WebSphere® Business Integration Modeler correspondence-workflow management system

Scenario:
A leading healthcare insurance provider needed to improve customer satisfaction while reducing costs. The insurance provider also needed tools to measure productivity and employee utilization.

Objectives:
Develop and implement a correspondence workflow management system allowing mail to be imaged and then electronically routed for real-time, on-line processing.

IBM solution:
A custom-built workflow and monitoring management system that automatically routed correspondence images and information to business teams and individuals. IBM provided expert support in business process modeling, workflow integration, monitor development, and implementation services.

Overview and results:
Our client was faced with declining customer satisfaction caused by the manual processing of member and provider correspondence. Numerous, sometimes conflicting, internal policies that allowed regional business units to dictate how the correspondence would be processed added to the delays.

The first task was to build a model of the As-Is correspondence process. The As-Is model was used to determine how the process could be streamlined to meet the company's goals of reducing cost and improving customer satisfaction. The first challenge was establishing consensus among the regional business units on how their individual correspondence processes worked. The company also faced issues of the differences in each region's organizational structure and terminology.

The regional business units elected to use a corporate business team to oversee the project. The To-Be model was created rapidly because the team was well organized and focused on its objective. IBM coordinated the activities of the corporate business team and IBM to build a business process model that was used to design and develop the purposed solution.

The new process model used electronic correspondence and information technology that automatically sorted and routed correspondence to the appropriate business team or individual. First, state-of-the art scanning technology was used to convert correspondence into an electronic format. After the correspondence was scanned and indexed, a workflow engine sorted and routed the correspondence. WebSphere Business Integration Monitor then generated historical and real-time reports for the client's front line supervisors and management.

Implemented technology:
The technology used to provide this solution was WebSphere Business Integration Workbench, WebSphere Business Integration Monitor, and the WebSphere MQ Workflow product suite. The client's internal IT department used XML and Java™ to provide the user interfaces and standard messaging formats.

Customer benefits:
Analysis based on the IBM-created To-Be model generated the following projected three-year savings projections: