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How Sedgwick improved the security & efficiency of claims payment approvals

Experience 2013: A preview of Sedgwick’s session

Sedgwick's new batch payment approval process: Security and efficiency gains, and how iVOS users can get similar benefits

describe the imageI recently spoke with Thom Baxter, Applications Development Manager, and Kashia Farmer, IT QA Supervisor, of Sedgwick Claims Management Services, Inc., about the topic they plan to cover at the upcoming Aon eSolutions 2013 Experience Conference in Atlanta.

As a third-party administrator, Sedgwick had a particularly pressing need to optimize its payment request and approval process. The result has been an enhanced set of processes that have been very popular with approvers and examiners alike.

What topic do you plan to cover in your session?  

Thom Baxter: We plan to discuss a new batch payment approval process in the iVOS claims administration system that we rolled out in April of this year. We think it’'s a unique setup and something that is noteworthy because of two main benefits: first, the security enhancements (specifically, automated, progressive payment-approval levels). Second, the improved efficiencies (specifically, greatly streamlined payment-approval processes for Sedgwick employees who have to approve the payments that our examiners request).

Would you please discuss the security and efficiency objectives of this new batch payment approval process?

Thom Baxter: In terms of security, we're required to have anywhere from one to three levels of approval on all payments above a certain amount. We have this requirement for multiple levels of approval in order to protect our clients and prevent fraud.

For this new payment approval process, we wanted to make progressive payment approval levels, based on defined security levels and limits, integral to the process. We wanted to put the proper scrutiny on the claims to ensure that the appropriate payment levels are being reviewed and processed in a timely fashion.

Kashia Farmer: Another reason we we're doing that was to get more efficient. Specifically, we wanted to reduce the amount of time that approvers have to take to approve payments. At the administrator level, we wanted to be able to quickly find and easily modify approval levels as needed.

In short, we wanted examiners to be able to secure approvals for the payment requests they'’ve made as soon as possible, irrespective of the level of approval or approvals needed for the request. In turn, we wanted to make it easier and much faster for approvers to review payment requests and approve or deny them as appropriate.

Could you please describe the new batch payment approval process you're using in iVOS?

Kashia Farmer: When requests for payment are made, approvers use the batch payment approval page to review requests. As part of our security setup, payments cannot be approved from the payment entry screen.

With the new process, an approver can process all of his or her payment requests from within their queue. The approver can approve multiple requests —in batches —rather than having to make one approval or denial at a time, wait while the system processes that response in real time, and then move on to the next payment request.

What happens is, the person goes in and they check off the ones they want to approve. They can check off all or some of them, then they can go on and do other things. There’'s a job that runs in the back end that picks up payments every 10 minutes, and it will go through and process them, and it will actually, if they go to their queue button, it sends anything back to the approver that did not pass. Then they can go ahead and investigate those, fix them, and mark them for approval again.

Thom Baxter: The new process allows approvers to see anything wrong with a request, ask for it to be fixed and then receive a new payment request that’s been corrected.

In many cases, there are two levels of approvals that need to occur, and three levels in some cases depending on the amount. We’'ve set up the system so that approvals can be happening at the same time, meaning the first approval doesn'’t have to happen before the second approval can be submitted. As long as the necessary approval or approvals have been made before that batch job runs, the check run will be approved.

What’s the feedback been from within Sedgwick?

Kashia Farmer: One of our main reasons for going to this method was to give people back more time in their days, so they wouldn’t have to wait around for each individual approval. Approvers love the fact now that they can go through and batch them up, and if they don’t want to wait they can move on and come back.

Thom Baxter: Consider this example. You’re an approver with 25 payments to process. In the old system, it could take one to two minutes per payment to process, and during that time, you’'d have to sit there and wait while each one is completed in real time. That could be 30 to 40 minutes out of your day, several times a day!

In the new process, you review of all the payments that are on your screen, select approve or deny for each request, and press a button to submit approvals all at once. Right there, we'’ve saved an hour of the approver’s time, usually multiplied by several times a day.  

Sedgwick is a TPA, which means you handle an exceptionally high volume of payment requests. Do you think other, non-TPA iVOS clients could benefit from learning about and possibly applying Sedgwick’'s new batch payment approval process?

Thom Baxter: The batched approval process is especially useful for us, but it can help any organization improve efficiency. I think this session is really open to anybody that has a need to process payments. I don't think it's limited to TPAs.

I’'d also add, I think that enhancing approver levels and processes in a way similar to what we’ve done is just a good business practice for any organization. Moreover, other iVOS claims admin software clients don'’t have to follow our model exactly; they can pick and choose what works for them.

For example, in our process, we use a different batch payment approval page than other iVOS users do. It was newly created for this purpose and to accommodate the volume of requests we process. Many other clients wouldn't have to take create such a page; instead, they could continue processing approvals in the queue functionality, with security levels being independent of the batch payment approvals screen.

Vibha Pant is an account executive with Aon eSolutions. Email Vibha at vibha.pant@aon.com.

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Aug 28, 2013

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