As the largest health insurer in the state of Michigan, this Solimar Systems user is a nonprofit mutual insurance company founded in 1939 serves 4.5 million people within Michigan and another 1.6 million people in other states. The insurer’s social mission programs reach nearly every area of the state of Michigan and focus on three main objectives: improving health, increasing access and enhancing the quality of care.

With over 8,000 employees and offering the largest network of doctors and hospitals in Michigan, this health insurer designs, sells and manages health benefit plans for individuals, families and Michigan-based employers, including: traditional, PPO, HMO, Medicare, Medicaid, wellness, dental & vision, state and international plans, as well as plans with health spending accounts.

As Michigan’s leading health insurance company they have been recognized for several achievements. They have received many awards for their innovative health care programs, diversity practices, community leadership and dedication to the customer experience.

Solimar Systems interviewed Jose Franco, Team Lead Operations Development to discuss how implementing their Solimar solution has allowed them to streamline production workflows, lower production costs and reduce the turnaround time of projects.

The Challenge

The health insurer is required to develop and distribute several different types of documents, including explanation of benefits statements (EOBs), checks, member correspondence/letters, internal reports, direct mail, and more. Each type has its own requirements and production challenges. They identified four objectives they sought to implement to improve the workflow of their document communications:

The insurer was using older technology and not yet leveraging bar codes on documents or checks. This manual workflow led to errors resulting in member data being mailed to the wrong recipients and addresses. When this occurred, each affected member was required to be sent an incident notification letter alerting them that their personal information had been exposed. Consequently, the insurer would need to bear the cost of creating new incident notifications, getting it reviewed and approved by the legal and communications departments, and absorb all costs associated printing and mailing. In addition, each affected member was required to be offered a Credit Protection service for a year that was also paid for by the insurer.

“Depending on the situation, the recovery cost of protected health information incident notifications can be high,” said Franco. “We needed to develop and implement well managed workflows where we could essentially eliminate data and information breaches and the associated costs to address it.”

The Solution

The insurer explored various industry solutions to help modernize their document production workflows. After a systematic analysis, they chose the Solimar® Print Director™ Enterprise (SPDE) system as the most complete offering for their needs. In addition to SPDE, they also implemented Rubika®, SOLindexer™ and SOLfusion™ to manage post-composition document re-engineering while optimizing inserter and USPS postal workflows. The SOLsearcher™ Enterprise product was also included to enable document web presentment and electronic document delivery.

Electronically merging the checks and related documents greatly minimized the number of member data exposures, thus reducing the number of times credit protection had to be offered. The insurer also used Solimar to help count the number of pages per document and pass that information to 2D barcodes allowing the inserters to track at the page level as well as the document level. This modern workflow reduced the risk of pages from one document getting mixed with another document.

“The Solimar system we configured was the best software solution for our environment,” stated Franco. “We now enjoy Six Sigma quality control with increased automation and at much lower production costs.”

SPDE coupled with Rubika and SOLfusion gives the insurer a powerful solution that provides several ways to streamline workflows through automation. Rubika is an award-winning post-composition document re-engineering solution specially designed to automate manual processes, maximize postal savings, and enhance print data, such as adding barcodes. Unlike other solutions, which rely on custom programming, Rubika requires no coding at the application level and provides an intuitive user interface to rapidly implement production modifications where needed.

SOLfusion is a centralized application that automates multiple sets of output production tasks to support business-critical workflows. SOLfusion supported tasks include external processes, scripts, document indexing and execution of Rubika configurations for document re-engineering.

The Result

Since implementing the integrated Solimar solution, the output process has become much more efficient and with higher levels of quality control. “With our new Solimar solution our new production workflows are streamlined,” said Franco. “With the increased efficiencies from our Solimar solution we were able to increase our production capacity without adding incremental personnel.”

The new highly efficient and cost effective solution allowed them to produce their own internal work plus acquire additional work from other insurers. “Using Solimar, we were able to take on supplementary work involving nearly 12 million EOBs per year,” stated Franco. “We were able to increase our EOB production volume by 150% and bring back over $250,000 of work to our operation that was previously outsourced.”

Through the implementation of the Solimar solution the insurer was able to accomplish the objectives that were set for the new system: print to mail production costs were reduced, information errors were eliminated, production capacity increased, and processes were standardized.

The Solimar solution is used to solve a variety of challenges and can be configured in many different ways to increase efficiencies. “Our Solimar solution has reduced our development resources costs by $100,000 per year,” said Franco. “In addition, our document turnaround windows decreased by an average of 14 days.”

Their overall experience with Solimar’s technical support has been positive and timely. “The Solimar technical staff was very helpful with the system setup and initial startup,” stated Franco. “Their knowledge enabled us to get started and continue our migration to use Solimar products with ease and in a timely manner.”