Technology Decisions, August 2003, Feature Story : Master Piece

We were doing so much at the desktops as well as other development that was going on here involving Microsoft products, says Mudra. We wanted to figure out if there was a way to [implement a new system] in the Microsoft world.
Mudra began by screening approximately 125 vendors on a list that eventually was whittled down to five, all of which claiming they had a client/server claims adjudication system. Of the five, only two used Microsoft technology, and only QCSI did everything in Microsoft. QCSI did not have a dental-specific product on the market, though, so Delta professionals worked with the vendor to get what they wanted.

Mudra says training on the new product was a significant improvement for the carrier. On the old system, to bring a person off the street would take about 12 weeks from start to finish, he says. With the solution we were able to put together with QCSI, we are able to accomplish the same amount of training in about two weeks.

The users have been pleased with the conversion, too. Users all love Windows, says Mudra. Everything is at their fingertips. And if it isnt, we can make it happen quickly. After retiring the punching bag, Mudra says the manager of the customer service department told him, You know, I hated you during the conversion. Now you have made our lives so much easier.
Delta Dental Missouri uses N-tier architecture with a Microsoft client/server. Among the Microsoft units in the system are a Windows 2000 Datacenter, a SQL 2000 Enterprise Edition, and Visual Basic. The system integrates well with other tools such as Microsoft Office, Crystal Reports, and Business Objects, says Mudra. We wanted one server that could grow with us and not be outdated in two years. That is why we chose the Unisys ES7000. It is scalable to 32 processors and different models as provided by Intel.

One benefit for the carrier has been its ability to take on new business without increasing personnel. Before this system, Delta had to add an employee when the customer base grew by 5,000 new members. Today, it takes 40,000 new members before the cry for help goes up. The reason for that is the improvement in the adjudication rate.

He points to three factors for this improvement: having a rules-based system, having the data available on the system rather than through a service bureau, and the fact the insurer knows how to use the product. My goal is by 2005 to get it upward of 87 percent, he says.

Mudra is proud of the work that went into this project from Delta and QCSI. We were the first dental insurer to utilize an end-to-end Microsoft client/server claims adjudication system. We had the opportunity to invent the future for ourselves, and this relationship has delivered. ROBERT REGIS HYLE

CaseFile
The Problem: Dental insurer wanted to improve claims efficiencies without abandoning its Microsoft roots.

THE COMPANY: Delta Dental of Missouri?
WEB SITE: www.deltadentalmo.com
NET ASSETS: $29.9 million

THE SOLUTION: aQDen from QCSI
WEB SITE: www.qcsi.com

DOCUMENT MANAGEMENT
Spending for a Happy Ending

Providing better customer service makes carriers smile when they can save money at the same time.

Hastings Mutual Insurance Co. found itself in a bit of a fix when its document management vendor informed the carrier it would no longer support the software version used by Hastings. With more than 20 million documents in its possession, Hastings had some difficult decisions to make. Could the carrier support the old system internally, keep the code, and do what it could with that code? Or did the carrier need to make a large investment with a new vendor to move forward?

The issue became clear once the carrier examined things closely, Ruth Fisk, support services manager for Hastings, believes. In the insurance industry, one of the things that sets us apart from our competitors is customer service, she says. We dont sell a product. We sell something that is intangible, so customer service is where its all at. We needed to be able to look continually at ways to provide better service.

Hastings had spent in the six figures to make the existing system Y2K compliant, according to Fisk, so the carriers executive team wasnt excited about walking away from such an expenditure.

A group from Hastings went to work determining what the insurer needed for the future. We needed an enterprise solution for multiple projects, she says. We needed to look at electronic distribution, and we needed to have a central depository for all of our policy forms. With the old technology, the turnaround time was five to seven days before a document was reviewable in the system. It wasnt meeting our service needs, she says. Also, it did not offer any workflow functionality whatsoever.

The insurer designed project requirements. We were going to need it to have workflow, a document management system, a whole enterprise solution, and to provide electronic document distribution, she explains. And it had to be a company that could manage the conversion.

Hastings reviewed eight software vendors before it made its selection. Hyland was an established company with steady growth, says Fisk. She ticks off the list of positives about the vendor and its OnBase product: superior functionality, multiplatform, powerful host integration, and flexibility. Insurance companies do the same processes, but we all have our unique underwriting guidelines and the way we process claims, she says. The flexibility of this system was going to allow us to build it around our business processes rather than change our processes to meet the product, [which] was important to us.
Hastings and Hyland signed contracts in April 2002, and four months later the system was online with the first phasegetting the archival documents and the conversion up and running. Of the 20 million documents that needed to be converted, Fisk reports all but 16 of those documents were transformed. We didnt expect that good of a success rate, she says.

Today, every document Hastings re-ceives in the mail is scanned and immediately placed into workflow. Fisk says the OnBase system allows the carrier to expand the use of the system into other parts of the company. The carrier currently is rolling the human resources department into the system, and accounts payable will be coming after that to join claims and underwriting, which are already up and running.

The initial reluctance of the Hastings leadership to invest in a new system has disappeared as the carrier has compiled an outstanding return on its investment. Our total expenditure was $1.7 million, says Fisk. That expense included the software, the conversion, and replacing some hardware with a new clustered environment. There are smiles all around Hastings as the company recouped its investment within seven months, according to Fisk. She says the company projects a $2.5 million annual savings with the new system.

Source improvements and labor savings are great, but what pleases Hastings the most is its improved efficiencies. Thats whats most important to us, she says. To be able to provide better service, turnaround times, more accurate information, and no lost documents. Weve had no lost documents in a year, compared to what we went through before10 or 20 a week. It got so you couldnt throw anything away. Today, we keep paper for a week, and then we pitch it.ROBERT REGIS HYLE

CaseFile
The Problem: Carrier needed to convert to integrated document management solution that contained, among other things, better workflow.

?THE CARRIER: Hastings Mutual Insurance Co.
?WEB SITE: www.hastingsmutual.com
NET WRITTEN PREMIUM: $265 million

?THE SOLUTION: OnBase from Hyland Software
WEB SITE: www.hyland.com