End-to-End Group Quoting Process

A US-based health care insurer needed a tracking and processing system for their prospective and existing clients.

The Problem

As part of their yearly sales process for small and large groups, our client quotes many products to their current and prospective clients. They needed a system that allowed them to track both the quoting process and the way sold products were processed, from setting up membership through to processing claims. They originally spent more than a year building an application to do this, but the results were not what the business needed or wanted. As a temporary workaround, our client began to use a spreadsheet that tracked work as it moved from stage to stage within the Pega application. However, the process was extremely manual, requiring significant manual data entry, and therefore contained considerable risk of error.

The Solution

Rulesware was brought in both to revamp the application in order to make it more manageable for our client’s end users, and to improve the overall business process to reduce risk and provide visibility to the organization. The team spent a few weeks analyzing the needs of the business before helping to redesign the business process and the application using Pega’s Group Sales Process Manager (GSPM).

The Result

In delivering this project, the Rulesware team created a single end-to-end process, reducing manual data entry and introducing SLAs and increased visibility to applications throughout the process. The project represents a second successful delivery to this client. (Rulesware successfully delivered an Appeals and Grievances application for this client that went live earlier in the year.)

For more information on how Rulesware and how we can help your company achieve its goals, please contact us.