AB/IME Files: The Importance of Workflow-Based Document Management

By Sean Cassidy, Vice President – Sales & Marketing, Benchmark Independent Medical Examinations

Toronto, ON (Apr. 21, 2016) – It is widely acknowledged that of all the different types of insurance claims, Accident Benefits (AB) is the most document-intensive, requiring vast amounts of information on an array of forms to be shared among various parties, such as legal representation and Independent Medical Examination (IME) companies, often over the course of multiple years.

The other compounding factor of this document management challenge is that the medical community remains largely paper-based, and this information can represent a large portion of the contents ultimately destined for an AB file.

Recent estimates indicate that 15% of all documents are misplaced and, according to a Gartner study, 7.5% are completely lost. As a result, approximately 20% of an average worker’s day is spent searching for information, and when they do manage to find the desired documents, 90% are shuffled and need to be organized – which leads to additional lost time and productivity. Even after locating the appropriate document, they need to validate the version of the document they have, ensuring that they are working with the latest version.

At the end of the day, it has been clearly demonstrated that professionals spend more time searching for and organizing documents than they do actually reading them and working with the information. This does not factor in additional time taken due to the redundant effort of re-requesting the 7.5% of lost documents, which also impacts a third party’s efficiency because they must go through the exact same process to locate the lost document and re-send, which results in a vicious circle of wasted time.

There is no question that efficient document management provides a challenge for any type of business, and the challenges are compounded for AB due to the inherent complexity of the files. That is why we have taken an innovative new approach at Benchmark IME: we looked differently at document management and really scrutinized what truly constitutes effective document management.

We believe the process should not be focused solely on management of the documents, but a more globalized approach should be taken reviewing the organization’s goals and objectives and the corresponding employees’ duties required to efficiently achieve these outcomes. As a result, an effective system should bring together all of an organization’s information (as well as any external party’s) and tie it to a workflow so that the information becomes an organizational task-based asset rather than just a stand-alone document. In short, a given document should be available to all parties who require it and have appropriate permissions to view it, should be inaccessible to those without appropriate permissions, and should be presented at the correct time/point in the workflow.

In order to achieve this, Benchmark utilizes a single system, ExpeFlow, to store, share, and manage all workflows and associated documentation. Studies suggest that in most companies, roughly 80% of the information and documents are stored as unstructured data, which results in unnecessary redundant usage of network storage devices and bandwidth because the documents are dispersed everywhere across the enterprise rather than centralized. In addition, because it is unstructured, no record exists of who has viewed or edited a document, and this makes it difficult to follow an audit trail to uncover sources of mistakes or inefficiencies. Since Benchmark utilizes a single system, these issues are avoided and best practices can be put into place which we will discuss below.

Our last article reviewed ExpeFlow’s use of roles-based access control (RBAC), and by utilizing this type of access control it provides organizations with far stronger rein over document security and access. Confidential documents can be made available only to the people who need to see them, and by predefining who can access which types of documents, document management systems avoid the problems that arise when you depend on simple document password protection.

However, in order for document management to be truly effective, it must go beyond access control and audit history by tying document management to the actual corporate workflow which, in essence, translates into workflow automation and proactive workflow-based document management.

Benchmark has utilized ExpeFlow to customize all of our internal ISO standardized processes and tied each one of our key milestones to an automated workflow task. Each task is assigned a standardized time value for completion and the system tracks the whole process on an automated tracking sheet and alerts the necessary parties if any part of the process starts to deviate from the prescribed timelines. Document management has been tied to the processes so that when tasks are completed and events such as packages are executed, a customizable and predefined set of documents, routing rules, and the hand-off process are automatically sent to the appropriate parties. When multiple parties need to work on a single document the file is routed according to the prescribed business rules so that each user receives the document at the appropriate point in the process.

Ultimately, the purpose of this workflow-based document management is to streamline the business process by creating access to the required document when it is needed so that professionals can stay focused on the task at hand, rather than being forced to deviate from their thought process engagement to locate and/or manipulate a document. This type of defined document task-based relationship is what directly impacts the statistics and ratios presented at the beginning of the article.

Robust search capabilities are also required for when a user needs to quickly locate an archived piece of information, and to best achieve this, ExpeFlow mandates document labels and tagging, which is what provides Benchmark and all third-party users with the ability to rapidly search for and locate a particular document. As a result, time is saved and a higher-quality final product is produced, because all users can rapidly find the information they are looking for, providing them with more time to complete their work and less potential for errors and/or missed content. At Benchmark, we have realized the benefits of workflow-based document management and track the difference – our business objective is to enable our staff and all third parties to become more productive through increased focus on the task at hand as opposed to managing documents.

To further enable all parties in the workflow, we are aware that many of today’s professionals are constantly in motion and must have constant access to important files and documents. To achieve this, we have ensured that our implementation of ExpeFlow is fully mobile-enabled, device-agnostic, and cross-browser compatible – we want people focusing on their IME work, not their administrative and hardware-based challenges.

Effective document management tools must also be flexible enough to be integrated with third-party platforms, portals, and other assorted back-end systems. Ultimately, the true test of any system, such as ExpeFlow, is customer satisfaction, and re-keying data does not lend itself well to this important metric. Benchmark has integrated ExpeFlow with HCAI and is capable of integrating the system with any other client system through a variety of methodologies including common ones such as webservices or REST APIs that are capable of linking the systems together in real-time. This sharing at the source further reduces redundancies, eliminates re-keying errors, and allows workers to spend more time focusing on strategic tasks as opposed to administrative tasks.

We believe this article has made it abundantly clear the many advantages Benchmark has gained from adopting ExpeFlow and moving to true workflow-based document management; however, we would be remiss if we also didn’t point out the “green” benefits of the system.

“Going green” is an ethical step that Benchmark wanted to take, because if all businesses do their part to reduce impact on the environment, we will all benefit in the end. Benchmark now saves thousands of sheets of paper annually, and not only is this tremendously environmentally friendly, it also reduces costs, which results in a win-win situation for all parties involved – and that is Benchmark’s ultimate goal in all business transactions.

About the Author

Sean has been active in the insurance claims handling space in various capacities since 1997 and was one of the pioneers of Canada’s first online claims management system launched in 1999. Sean has expertise in claims, claims process improvement, vendor programs, claims IT systems, and document management. He enjoys working with insurance companies to tie all of these components together with their various systems and processes in order to arrive at the ideal combination customized to an insurer’s own unique needs. Sean joined Benchmark IME in December of 2013 and is putting his experience, coupled with Benchmark’s advanced technological capabilities, to work to improve the AB claim workflow for insurers in Canada.

Sean can be reached at [email protected].

About Benchmark

Technology-driven, person-centered philosophy, and privately-owned and operated by a Regulated Healthcare Practitioner – we only provide Independent Medical Examinations (IME). Benchmark provides a comprehensive range of IME with national coverage to Property and Casualty Insurers, Group Life and Health Insurers, Government, Employers, and the legal community. Benchmark is CARF accredited and has a management process that is ISO 9001:2008 certified.

Source: Benchmark IME