Automation eliminates manual data entry between case management and insurance policy admin platforms. It monitors work queues for new policies, and extracts and uses business rules to transform policy application data (e.g., type, payment plan, address). The information is loaded into the target admin platform for underwriting. MI operational reports are generated for completed cases, exceptions, and policy statistics.
Automation applies unapplied payments to client policies. Unapplied funds and open accounts receivable reports are retrieved from the financial systems using the existing reporting tool. Data required is extracted and transformed for use by the process. Using business rules, it searches premium receivable data, matches the payment to the right policy and applies it in the admin system. A management reconciliation report is generated for the processed matches.
Third-parties provide requested data in XML and other file formats. For example, the automation parses and transforms the medical and background information during attribute extraction processing. Within the new business case management system, the automation locates the right insurance policy applications and uploads the transformed data. Case reports are also produced for use by the underwriting team.
WonderBotz team members built an extensible framework automation that utilizes the ServiceNow API to receive, update and close tickets and RPA connectors to interface to individual target applications and the AD groups. Target applications are added to scope based upon their total annual volume of access requests from highest to lowest. Activity reports are generated daily for infosec review for ongoing SOX compliance.
Automation finds timecard exceptions, notifies managers and escalates issues. It extracts incomplete timecards from Kronos and uses business rules to identify exceptions. Depending on the reason and circumstances, it signs-off on unapproved timecard or alerts appropriate manager for their action, either in batches or one-by-one. If a manager has multiple employees with issues, the messages are consolidated into a single alert. Over set time periods and until issue resolution, the solution escalates three times (i.e., manager, manager’s manager, etc.).
Automation established a high-volume processing framework to perform initial in-scope service transactions and that was also extensible to rapidly add more service transactions as needed in the future. Solution connects to and monitors the Insurer’s AWD case management system for service requests, applies business rules for handling instructions and makes required adjustments to policies and contracts in the respective admin platforms, including confirming success and closing the case.
A joint client/ WonderBotz team worked closely together to scale InvoiceBotz processing scope by adding more vendors and templates to the existing program. Using existing WonderBotz InvoiceBotz functionality, the joint team identified new vendor invoices to be added, grouped by high and low volume, region, and formats, and expanded the business rules to further verify extracted data to improve confidence levels and OCR data quality.
The solution gathers the draft bonus plans that have been created for each employee. Next, it identifies the right approver for each plan and requests that they perform the required review. First-line and next-level managers work together until they align on a final plan that conforms to policy. After an employee’s plan is approved, the automation loads the plan into the defined bonus letter template, creates a PDF file with password protection and delivers the PDF file to first-line managers for secure distribution.
While not diagnosing a medical condition, the automation uses patient data from medical evaluations performed by registered nurses (RN). Applying rules to medical codes entered by the RN, it sets the patient’s status as “normal” or “SIA”, and, as applicable, sends SIA alerts to the individual members of the patient’s direct care team advising that they need to immediately get to their patient. It results in improved patient care, services for their families, and revenues for the organization in support of its mission.
Automation enables immediate action on referral. Using simplified data-entry screen, intake team and referring physician work together to load the patient’s medical data into the system (e.g., diagnoses, demographics, insurance coverage, circumstances). Using rules and workflows, automation (1) identifies follow-up admission tasks and required face-to-face visits, (2) assigns the direct care service team by location, (3) prepares electronic medical record and (4) provides draft clinical notes to care team for review and submission.