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Table of Contents
1
INTRODUCTION
CBM is one of the nation’s largest benefits administrators for self-funded health and risk management plans. They are client’s strategic partners and provides them with right plan for their business. They tailor plans according to the need of the client and provide third party administration services which help clients keep their health care costs as low as possible.
CBM generates reports for its clients by 15th of each month. It looks up all the monthly reports from previous years and after processing the claims and other information, generates monthly reports. It advises its clients on their budget plan based on the client history, health of its employees and expenditure capacity.
CURRENT SCENARIO
Currently, the finance team has to collect and process vast information coming from internal and external sources. This information has to be manually entered by the team into excel sheets to generate reports. It generates separate reports for medical and dental claims. It further details on Inpatient, Outpatient, Prescription drug and Major medical claims separately. Since the filing and data entry procedure is manual, it can cause errors in the generated reports. The finance team has to collect data from internal teams like accounting, operations, beneficency and external sources like clients, stop-loss coordinators, providers, pharmacy vendors, etc. It has to collaborate and coordinate with all the teams and thus can lead to time delay at times. Also, the menial efforts of the team cannot be efficiently evaluated as there is no metrics system to measure it. The financial analyst has to decide the budget rate, calculate monthly budget, generate reports after manually filing data into excel sheets after collecting paper copies from various departments. This process being manual can induce human errors and can be time consuming.
In the swim lane diagram below, we can see the flow of the
1
INTRODUCTION
CBM is one of the nation’s largest benefits administrators for self-funded health and risk management plans. They are client’s strategic partners and provides them with right plan for their business. They tailor plans according to the need of the client and provide third party administration services which help clients keep their health care costs as low as possible.
CBM generates reports for its clients by 15th of each month. It looks up all the monthly reports from previous years and after processing the claims and other information, generates monthly reports. It advises its clients on their budget plan based on the client history, health of its employees and expenditure capacity.
CURRENT SCENARIO
Currently, the finance team has to collect and process vast information coming from internal and external sources. This information has to be manually entered by the team into excel sheets to generate reports. It generates separate reports for medical and dental claims. It further details on Inpatient, Outpatient, Prescription drug and Major medical claims separately. Since the filing and data entry procedure is manual, it can cause errors in the generated reports. The finance team has to collect data from internal teams like accounting, operations, beneficency and external sources like clients, stop-loss coordinators, providers, pharmacy vendors, etc. It has to collaborate and coordinate with all the teams and thus can lead to time delay at times. Also, the menial efforts of the team cannot be efficiently evaluated as there is no metrics system to measure it. The financial analyst has to decide the budget rate, calculate monthly budget, generate reports after manually filing data into excel sheets after collecting paper copies from various departments. This process being manual can induce human errors and can be time consuming.
In the swim lane diagram below, we can see the flow of the