Materials Distribution Management System for a National TPA
Business Problem:
A national TPA is responsible for distributing benefits information and related materials to the employees of over 3,000 client companies. This requires coordinating the activities of many departments that produce items such as literature, membership cards, claims forms, etc. There can be anywhere from 10 to 300 tasks required to establish, maintain or renew a client. Most of these tasks when completed trigger additional tasks to be performed. The manual, paper-based system was found to have too many places where the process could be interrupted or where paper forms could be lost or sent to the wrong person.
The TPA desired desired a workgroup collaboration solution that would initiate, control, facilitate, and monitor all aspects of the distribution process.
Solution:
RESolutions Consulting developed a Lotus Notes/Domino workflow application that allows a single place where everyone can view all the information on a client such as contacts, phone and fax numbers, the number of enrollees and the types of coverage provided to the clients. In addition, all the tasks that need to be completed can be viewed along with the task status. As forms are filled in and tasks are completed, email reminders using doclinks are sent to people or groups informing them that they are required to perform some type of action.
System functionality included:
- Client Profile and Related Setup Forms All the client data is now stored electronically. All secondary forms are initiated from the client profile and have links back to the parent document.
- Master Tasks Lists Multiple tasks lists have been created which contain the prerequisite tasks, start and end dates and the department or person responsible for completing the task. When the task list is run for a client, email notifications are automatically generated informing people to begin work on the tasks.
- Ad-hoc Tasks In addition to the predetermined task lists, ad-hoc tasks can also be created for a client.
- Keyword Maintenance The system was designed to allow supervisors to create, edit or delete the keywords that are used in the drop down fields. This allows the system to easily be modified over time without the need to change the coding in the system.
- Distribution Lists The system allows multiple distribution lists to be created and used for sending email messages with links to the appropriate form or task that needs to be completed.
Return on Investment (ROI):
The following is a partial list of the ROI achieved by the TPA:
- All client information is accessible from a centralized location
- The status of any particular task is now easily viewed
- Tasks can easily be reassigned to balance the workload
- Automatic email triggers inform people when it's their turn to complete a task
- Various types of reports can easily be created from the information stored in the application
- Keyword lists are integrated and automatically updated from other systems within the company
- The workflow process is more efficient and bottlenecks in the workflow are easily spotted and resolved
