When CareFirst Blue Cross and Blue Shield assessed its computer systems in light of Y2K, it realized that it had to replace its subrogation and workers’ compensation software package. By choosing iAutomate: OPL CaseManager from Insurance Automation Group, CareFirst not only solved its Y2K problems, it also boosted analyst productivity by 25 percent.
CareFirst, an independent licensee of the Blue Cross and Blue Shield Association based in Owings Mills, MD, is a not-for-profit health care company which offers a comprehensive portfolio of health insurance products and administrative services to more than 3.2 million members in Northern Virginia, the District of Columbia, Maryland and Delaware.
Sue Haynes is manager of the subrogation and workers’ compensation department of CareFirst and her group handles the entire Maryland and District of Columbia membership, including national accounts, HMO accounts, and indemnity business. This membership base generates a large workload for CareFirst’s subrogation and workers’ compensation department. Although Y2K prompted a system change, Haynes already identified that the prior outdated software package was handicapping her workforce.
“Our analysts were doing more manual work due to the lost functionality of the prior system, and we were struggling to keep up with a growing inventory,” says Haynes. “Before I could analyze our staffing needs, I had to address our work flow.”
“After we implemented iAutomate: OPL CaseManager, we could review cases and make notes without pulling paper files,” says Haynes. Analysts were able to use iAutomate: OPL CaseManager’s case diary system, which enables analysts to enter and share information electronically without locating and managing paper files. According to Haynes, CareFirst analyst productivity increased by 25 percent.
The increased productivity meant that CareFirst was able to hold the line on adding staff. "iAutomate: OPL CaseManager allowed us to work as efficiently as possible to handle all of the cases in our inventory,” says Haynes. “If it hadn’t been for iAutomate: OPL CaseManager, I would have had to consider hiring more analysts.”
iAutomate: OPL CaseManager also helped CareFirst quickly and easily generate reports that it needed to control inventory and monitor performance. “We know how many cases our analysts are reviewing, and their performance scores rely on that data,” says Haynes.
"iAutomate: OPL CaseManager is a very user-friendly system—analysts just point and click,” says Haynes. “It works very well in our environment, and it gives us exactly what we need.”