We are currently QA (Quality and Assurance) and testing processes for our new PI version of SCOUT and an implementation for a new Carrier client.  It's a somewhat complicated process and absolutely crucial for the success and adoption of the software.  I just came across an article that does a pretty good job of explaining what it takes to implement new software in an insurance environment.

 Highlights:

Step 1: Establish priorities. Identify the critical, most used, end-to-end business transaction pathways within the enterprise portfolio for the application.

Step 2: Develop the Architecture. Create an automation test architecture using the appropriate functional test tools. Make sure that the architecture supports the automated test script processing, while minimizing test script coding.

Step 3: Develop Test Case Templates. The templates are used for automating the application. Identify the key fields to vary in using data parameterization.

Step 4: Move the Data. Identify a full data migration solution from the legacy system, based on the necessary elements of the new application..

Step 5: Execute. Build and automate as many of the end-to-end test transactions for the application as possible, within the iteration’s user acceptance testing (UAT) schedules. Then, execute the test scripts (automated test cases) during UAT, report defects, and maintain a testing status dashboard for project status results.

This is a pretty good road map, but there are always exceptions depending on the environment.  We strive to set expectations with every customer and make the transition as smooth as possible.

After months of waiting we are seeing the first screenshots of our updated SCOUT PI Edition.  We are finishing up Q&A and some other finishing touches.  Still need to add the WorkPlan tab, Case Status Plugin, and allow for more than one Subject.

We've been hearing a lot about this over the past year in several discussions with our clients.  Data from the NICB paints a more vivid picture:

"....questionable claims (QC) during the first half 2010, found that QCs have skyrocketed in the past two years. The report examines six referral reason categories of claims—property, casualty, commercial, workers’ compensation, vehicle and miscellaneous...there was a 14% increase in QCs in four of the six categories in 2010 when compared to the first half of 2009."

Read the rest of the article here

Check out the icons on these buttons in the 2011 Ford Explorer.  Any idea what they are for?

It used to take 90 days before the government detected a scam. By then, the crooks were long gone, sometimes with millions of dollars. Now authorities get billing data as it’s submitted, allowing them to catch suspects in real time, “as opposed to the typical pay and chase model we’ve had for years,” said Gerald Roy, assistant inspector general for investigations.

Detroit is one of 5 cities involved in the largest ever Medicare fraud bust.

Read the entire article here.

Cost benefits come up in every conversation about implementing SCOUT with a new client.  In one way or another, every one of these are addressed during the sales process. I thought the issues were articulated very well in a recent article I read.

For any software search, cost benefits can be expressed in uncomplicated terms:

• Staff reduction
• Process improvement
• Regulatory compliance
• Cycle time reduction
• Employee training & retention

Read the entire and expanded article here from Insurance and Technology

I was re-reading an article from Insurance and Technology, 4 Technology Solutions That Sizzle originally written in December of 2009.  The first solution discussed is cloud computing and SaaS and starts off, "Insurers remain cautious in their adoption of newer technologies." We've been dealing this mindset for years and I'm happy to see that even in the past 6 months issues pertaining to data security are less prevalent in demonstrations and negotiations. 

A SaaS solution offers better back up and security for data for all PI companies even those who can afford a full-time IT staff.  Using SCOUT PIs own their data, it's backed up in multiple locations everyday by systems and procedures dedicated to such efforts.  There are generators and state of the art security systems protecting the servers where the data is stored as well.  SCOUT also uses the latest data encryption methods available. 

The same goes for Carrier's concerns.  Deploying a SaaS solution is no more and often times less risky than hosing a solution and data on-site.  I've also never come across an installation where it was cheaper to perform hosting functions on-site either. 

The case for moving insurance related software solutions into the Cloud is undeniable.

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I came across this article from Insurance and Technology that describes, "UIs need to be crafted not only to meet the task at hand but also the type of user." Really?

QUOTE: In developing the various UIs within its product set, StoneRiver has identified three different personas:

• the internal insurance professional or administrator;
• the external customer, including agents; and
• the systems administrator.

Aren't all of these just people and aren't they all using the same application?

QUOTE: For example, internal insurance professionals understand the concepts and terminology of insurance, Griffin explains. They are looking for speed and efficiency and can deal with more complexity.

So insurance "professionals" understand the insurance we buy better than we do or are superior in their processing capabilities?  Complexity = speed and efficiency?

Now, we didn't hire a Human Factor Specialist to design our UI, but I also don't think we need to complicate things with 3 (or more) different UIs.  Sure, different users have access to different screens and information in the application, but do they each need a custom design?   I'm not trying to pile on the company mentioned in this article and truth be told, I'm the litmus test for new features and layouts for SCOUT.  If I can't figure out how to use it we go back to the drawing board. 

Required training is minimal, barriers to entry low, adoption rates high.  We promise not to make our client's lives more complicatied.  Quite the opposite.

One of the biggest obstacles we have to overcome is proving Return on Investment for our products in the SIU.  The reason it's difficult to have exact numbers is because the exact financial impact of the SIU itself is sometimes in dispute.  I've read several studies and talked at length with clients about how SIUs prove value and ROI to the company as a whole and the consensus is there is there is no consensus!  Everyone knows there is some and often great benefits to a carrier having a department devoted to investigating and thus deterring fraud, but the specific financial impact is hard to discern.

Attached is a recent article by Robert Horst and Mark Rosenberg: The Business Justification for Special Investigation Units

"While these units may often be expensive, the proven effectiveness of SIUs in uncovering incidents of fraud and deterring future incidents of fraud ensures that they are one aspect of an insurance company's operations that is almost certain to pay for itself over time."

The Business Justification for Special Investigation Units.docx (16.14 kb)