Technology For Tomorrow's Insurance Company
Document management and imaging VARs will need to concentrate on more than just imaging if they want to stay competitive in vertical markets. The insurance company of tomorrow will combine many technologies, opening up opportunities for nimble VARs.
"Large healthcare companies like Cigna and AEtna easily receive 100,000 paper claims per day," said Jeffrey S. Grider, managing principal, insurance marketing and business development for American Management Systems, Inc. (AMS) (Fairfax, VA).
"Paper claims involve a large mailroom process. In the past, healthcare companies either microfilmed or stored information on paper. Starting four to five years ago, we began to see the benefits of EDM (electronic document management). Now paper can be scanned, kept for two to three days, and then discarded. All documents are kept as electronic images that every employee can access. We do a large amount of EDM systems. We usually provide 5.25-inch optical jukeboxes or 12 GB and 30 GB optical platters in jukeboxes. We do very little CD-ROM-based storage because it doesn't lend itself well to high-volume applications.
"When paper is scanned, images are typically committed to two platters, one to retrieve information from on a daily basis, and the other for archival purposes. Once a platter is filled, the user removes it from the jukebox to be stored off-site," said Grider. "This type of backup is cost-effective because it uses the same media and read/write mechanism for back up as it does for the data that is accessed daily."
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Horizontal or vertical? Document management and imaging VARs are becoming increasingly horizontal. Most businesses will need some form of document management as we move further and further into the age of information. Some VARs are afraid to be pigeonholed into one vertical market for fear that they may lose opportunities in another.
American Management Systems, Inc. (AMS) (Fairfax,VA), a $1.06 billion, 9,000-employee international business and systems integrator, is large enough that it can keep the vertical market touch while sprawling horizontally. AMS is involved in an array of verticals such as telecommunications, finance, healthcare, government, environment, utilities, and insurance.
AMS has been in the insurance vertical market for more than 10 years. According to Jeffrey S. Grider, managing principal, insurance marketing and business development, "We grew where we saw the need, where the market would take us, and where we could be a leader."
AMS offers consulting and development services - from strategic business and technology analysis, to electronic commerce, business process renewal, and change management, to the full implementation of systems. The range of technologies the company provides is as wide as its span of vertical markets.
"We provide technology such as data capture, a 401(k) record-keeping system, call center telephony, call center applications, claims payment systems, change management assistance, and data warehousing," Grider noted. AMS provides these applications to large companies like AXA Financial, Blue Cross/Blue Shield Plans, Metlife, and New York Life.
Managing Customer Relationships
AMS recently signed a strategic partnership agreement with Siebel Systems. The partnership provides a Web-enabled suite of sales and marketing tools. The suite can be used to coordinate and track sales and marketing activities through the insurance agents. It can also be used in call centers to track incoming calls. The suite also integrates with electronic voice response to streamline the process in a typical call center environment.
Interactive voice response (IVR), voice response unit (VRU), computer telephony integration (CTI), and interactive transaction processor (ITP) will become prevalent in the insurance industry, according to AMS. The goal is to make customer service more effective and have customer information instantly available.
E-Commerce Brings Big Bucks
"About 25% of our revenue this year will be e-commerce-related," said Grider. AMS developed the medicare.gov Web site for the HCFA (Health Care Financing Administration) in 1999 and continues to refine it.
"E-commerce has been a very large initiative in the last year. We do member and provider e-commerce applications," Grider added. "The driving force behind that is to reduce long wait times on telephones. When customers log on to the Web site, they can get information almost immediately."
Medicare.gov recently won two awards for outstanding service to the beneficiary community from eHealthcare World, a forum sponsored by eMarket World. AMS accepted a gold award for "Best Government Health Web Site" and a silver for "Best Web Site For Seniors/Boomers". eMarket World provides industry-specific Internet conferences, trade shows, and executive summits throughout the United States, Europe, and Latin America.
Insurance Company Of Tomorrow
How does AMS know in what direction to move when it comes to providing technology to its clients? Grider said AMS' Center for Advanced Technology's (AMSCAT) sole purpose is to look beyond today and begin to develop the technology its clients don't know they need yet. "Each year, AMSCAT goes through a reiterative process where it decides which technology to focus on for the following year."
Emerging today is a handheld computer, also called a PDA (personal digital assistant), that will likely be a large part of the insurance process in the future. Physicians and nurses can enter patient information during a doctor visit. The information is transmitted electronically instead of via a claim form. Reimbursement is done electronically. This process, EDI (electronic data interchange), involves no paper at all.
Smaller healthcare providers will be slow to adopt this technology, so the need for paper processing will continue indefinitely. Paper documents will be imaged with OCR/ICR (optical character recognition/intelligent character recognition) and then made available over the Internet. This is an important development for companies located in a tight labor market or geographically separated from the labor pool. "OCR/ICR will allow companies to have a large contingent of home-based data entry operators," explained Grider. "The home-based model addresses quality of life for working mothers and other people who have dual responsibilities. These people will have the opportunity to sit at a PC at home and do the same work they did sitting in a cubicle at the office. Many of our clients are interested in this technology."
Grider talked about the way the insurance company of tomorrow will affect the patient. "Today, when you walk into a doctor's office, you give your name to a receptionist. The receptionist pulls the file, asks for your insurance card, and verifies that you're a member. In the insurance company of tomorrow, you'll walk up to a kiosk and have one of four choices. You might log in with a user name and password. There might be a voice recognition option. It's in demo mode already. You speak, and the computer asks you several questions which you answer through a microphone. The third option might be iris recognition. You look into a fiber optic receiver, and it identifies you by the iris patterns in your eye. Or last, you might have a smart card with a microchip in it. The electronics on the card will have all the information you need to log into the physician's office."
With the Center for Advanced Technology, AMS is able to look into the future and position itself to provide total solutions for its clients. AMS is a huge company that can devote an entire division to research. Smaller VARs can apply some of AMS' practices to their own companies. The best thing they can do is keep their eyes open to new developments in technology and be prepared to offer new solutions to their customers. Opportunities abound in e-commerce and mass storage - as AMS has demonstrated with the "insurance company of tomorrow."