Reproduction Health

Like many insurers, Health Net ($3.4 billion in assets) increasingly relies on electronic storage of documents, including identification cards, letters of correspondence, remittance advices, grievances and denials of claims. But reassembling the electronic information - for electronic distribution or paper-based distribution - became a costly challenge, according to Robert Redding, director of IT group applications development for the Woodland Hills, Calif.-based carrier.

Locating the right code - which was stored in an Oracle (Redwood Shores, Calif.) database running the Unix Sun (Santa Clara, Calif.) Solaris operating system - was time-consuming, and the source code often did not produce a true reproduction of the original document, explains Redding, who likens reproducing documents from old code to trying to use a new application to read a document created with obsolete software. Additionally, because of large printing volume requirements, Health Net was forced to rely on a small group of print fulfillment vendors, which gave the vendors the upper hand in price negotiations, he relates.

The lack of availability of documents increased Health Net's litigation risk in the heavily regulated health industry and heightened customer dissatisfaction, Redding continues. "We wanted to improve customer communication and service," he says. "We wanted to be more efficient in the end-to-end process, from when the claim is made until the documentation is sent out."

Health Net sought a solution that would allow it to electronically archive fully composed documents that then could be retrieved and sent to customers via fax and e-mail directly from desktops, Redding says. The insurer began assessing document solutions in August 2003, whittling the candidates down to three vendors in October 2003: Document Sciences (Carlsbad, Calif.), Exstream (Lexington, Ky.) and Group 1 Software (Lanham, Md.). In March 2004, Health Net selected Exstream's Dialogue software.

It took about four months to deploy the Dialogue software, leveraging Health Net's existing IT architecture, though the carrier added an Oracle database to support the solution. The first area of Health Net to use Dialogue was the Northeast ID card division. The capitation, historical information and membership information departments started using the software later in 2004.

Dialogue enables Health Net customer service agents to send requested information via e-mail or fax directly from their desktops. The software also allows Health Net to store commonly used objects, such as tables, business rules and images, for reuse in multiple documents. Additionally, the carrier now has the ability to amend existing documents, by effective dates and jurisdiction, for example - if a change is made on one page, the rest of the document is updated automatically.

When choosing Exstream, Health Net forecasted that the software would save the company $40 million over five years. Though it has been deployed to just four of the company's 15 divisions, results in the first year are on track to reach that goal, according to Redding.

Electronic document reproduction lowers Health Net's printing and delivery costs, and the reduction in print volume enabled the insurer to widen its selection of vendors, leading to better fulfillment pricing, Redding explains. And Health Net isn't done generating savings with the solution. "This is an ongoing project," he notes, adding that he expects to expand use of the software to Health Net's 11 other divisions.

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Case Study Profile

Company: Health Net (Woodland Hills, Calif.; $3.4 billion in assets).

Lines Of Business: Health insurance.

Vendor/Technology: Exstream Software's (Lexington, Ky.) Dialogue document

management software.

Challenge: Archive and reproduce fully composed electronic documents.