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A Winding Road to Success

To manage an influx of claims processing documents for its TRICARE division, Wisconsin Physicians Service Insurance selected Cincom Intelligent Document Solutions.

It was a classic good-news/bad-news situation: After winning three new Department of Defense claims processing contracts in 2002, Wisconsin Physicians Service Insurance (WPS; Madison, Wis.; 2004 statutory assets of $210 million) faced numerous obstacles in the process of upgrading its legacy systems with more-scalable and flexible document automation software that could handle the volume of documents accompanying the new contracts. "The new contract would more than triple the volume of documents going through our systems," says David True, director of customer service for WPS. "We needed a more efficient and dependable system." WPS also needed to steer documents from the customer service contact center directly into the in-house claims processing system for its TRICARE division, which manages military health plans.

WPS used a homegrown COBOL mainframe document processing system with Top Down System's (Rockville, Md.) ALGS document automation application to create and deploy customer service claims documents. But keeping documents consistent was difficult because customer service staff could rewrite the standard letter, says True.

WPS wanted a system that would optimize its legacy investments, allow contact center personnel to insert claimants' information using a Web-based interface, and reduce document mistakes by granting letter authors sole access to document repositories. After looking at four vendors' products, WPS chose Cincom's (Cincinnati) Intelligent Document Solutions suite in December 2003. "We liked the flexibility of the system, the letters were quick and easy to create and manage, and Cincom had experience with TRICARE," says True. The suite is an automated document manager with a Microsoft Word interface that creates and delivers personalized business documents via multiple channels, including print, e-mail, fax and the Web.

In February 2004, Cincom installed the software onto WPS' two document-authoring Hewlett-Packard (HP; Palo Alto, Calif.) PCs. That's when they encountered a bump in the road: WPS' homegrown Web-based customer service application, ID Web Doc Services, which retrieves data from the carrier's claims system to eliminate customer service keyed-in errors, repeatedly shut down due to interoperability problems between the open source middleware network connection TC Express and the Cincom application, according to Terry Runkle, supervisor for customer service for WPS. "We couldn't get the stability we needed," he explains. TC Express was replaced with IBM's DB2/SQL middleware, and WPS was able to start running letters off the system in May 2004.

Reaping the Benefits

Once this was resolved, WPS finally saw the benefits of the document management suite. Because Cincom's application is tied into ID Web Doc Services, customer service representatives can generate the documents with more accuracy while they are on the phone. "We actually have reduced generation time from five days to 10 minutes," says True. The system is also easier for the staff to be trained on because the document is more structured, he explains. This has all led to WPS being able to generate up to 4.5 million documents in a year, tripling its document volumes.

Document Management

company

Wisconsin Physicians Service Insurance (Madison, Wis.; 2004 statutory assets of $210 million).

lines of business

Individual and group health, and TRICARE, which manages military health plans.

vendor/technology

Cincom's (Cincinnati) Intelligent Document Solutions suite.

challenge

Automate document processing to handle a large volume of claims processing contracts.

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