Apex built new Benefit Policy Change Management processes using IBM BPM which dramatically improved the accuracy, auditability and communication of changes.
Blue Cross Blue Shield of Michigan is a nonprofit mutual insurance company with over 6M members and works with a network of 33,000 doctors. BCBSM employs over 8000 people.
An important dimension of any medical insurance organization is managing changes to existing benefits. At BCBSM, a variety of methodologies and tools were utilized to initiate benefit changes resulting in misinterpretation, errors and gaps in communication to downstream systems and departments reliant on benefit information. This created barriers in customer servicing, and increased the complexity in maintaining the accuracy and integrity of information captured in the benefit information database.
The existing application design limitations contributed to increased incidents of corruption, resulting in risk of data loss, downtime and maintenance costs. Capacity and scalability issues to accommodate a growing user base (700+ users) continue to put the application at risk.
Apex defined and modeled Benefit Inquiry and Policy Change Request processes using IBM BPM. These streamlined workflow solutions served as a repository for all benefit change requests, simplifying the user experience for departments involved in the changes and automating communication of changes. The new solution increased the accuracy, information integrity and auditability of benefit changes performed by the organization.
