At Rulesware, we’re often asked for clarification on just what we do. As a BPM consultancy, we help organizations to analyze and optimize their business processes using Pega software.
People do understand that BPM, or Business Process Management, is all about improving and optimizing business processes but questions remain: what kind of processes? Are there big results? And what’s entailed?
To illustrate, we’ve summarized a few recent engagements that we’re really proud of, which highlight the potential of smart, sensible BPM solutions to not only fix pressing problems–but also to sometimes reveal hidden business opportunities.
Moving From Manual Processes: How Fixing One Problem Provided a Host of Business Growth Opportunities
In the case of one large health insurance provider, we were proud to not only fix one pressing problem with the system we implemented, but also to ensure that the system offered a range of options for business growth down the road.
The provider in question needed a more effective way to process its client appeals and grievances. No automated system or unified process existed to handle and/or resolve incoming grievances and appeals, and the client was using a range of disparate tools. They wanted to minimize manual transfers in the appeal and grievance process, provide a unified reporting and correspondence capability, create a single repository for automated correspondence triggered during the appeals and grievance process, and create standard correspondence templates.
The client was looking, first and foremost, for an immediate solution to clean up its appeal and grievance process, but Rulesware’s approach involved looking ahead, too.
“The way we looked at it was to focus on what they needed to be doing in their process, rather than looking at improving their current processes,” says Aaron Lee, the project’s Business Architect. “We looked at every way possible to automate their work processes to realize improvements in time and accuracy. And ultimately, we built them an entirely new system.”
Perhaps more important than building a new system was the fact that Rulesware employed best practices in Pega development, so that all functionalities in the application would be reusable and extendable in the future.
Ultimately, this means that in five or ten years, if the insurance provider’s business changes fundamentally, they will not have to re-engineer the entire application; rather they will be able to re-use the pieces that Rulesware built. And of course, the client also now has one uniform, and beautifully functioning process with which to move an appeal or grievance from intake to resolution.
Rulesware accomplished this project in just 16 weeks, with a small highly functioning team that worked in iterations.
Saving Money Through Automation and Dramatically Improved Communication
Our client–a large auto manufacturer–was manually completing much of their claims analysis and reporting, preventing them from being able to collaborate with dealers at the time of service, or to fully assess the nature of the claim before the service is complete.
Their ultimate goal was to pay only claims that met the specific rules and guidelines based on product, part, labor and operation codes.
After assessing the business problem and processes involved, the Rulesware team began work on a new Front End Analytics & Alerts software solution that obtains Repair Order (RO) information from dealers while a customer is at the dealership on the service drive. It continually analyzes RO data, comparing it to historical claim data, and delivers alerts to the company and dealership personnel about how to proceed with the repair.
The rules-driven system has ultimately reduced the number of warranty claim requests that do not meet the appropriate claim criteria, resulting in significant annual savings to our client in warranty claims.
Creating a Streamlined Process to Handle a Company’s Most Valuable Data
Rulesware was approached by a world leader in diagnostics testing, that was struggling with managing test data–one of its most valuable assets–effectively and consistently. Information was being lost, there was no formal way to track changes or approvals on tests or diagnostic data, and there was no clear visibility on the status of tests.
Our first order of business was to initiate a ‘pre-inception’ phase to the project, in order to clarify our understanding of existing process, and to ensure we were working in full partnership with the client. We then used Pega to request new or submit change requests to existing test data in all of the client’s databases.
Within 15 weeks, Rulesware has delivered a customized Pega solution, coming in under budget and on time. The client now has a streamlined process for handling test requests and test change requests, resulting in increased accuracy, shorter entry time and cost to market, and greater ease of use for team members.
Transforming a Troubled Intake System into a Key Component in Overall Business Process
In analyzing the solution Pega had built for one client, Rulesware noticed that this client’s intake process (essentially the way requests entered all of their many systems) was fragmented, disjointed, and highly inefficient.
Rulesware set out to create a system that efficiently functioned as the single source of intake for all lines of business at the client.
The client acknowledged that we fully accomplished their objective. Their single intake application is now a key component in their business process, ultimately helping to reduce overhead cost, reduce turnaround time, and reduce administrative costs and manual processes.
And we welcome your questions! Do get in touch: sales [ AT] rulesware [DOT] com.