claims

Syndicated from ebizQ Lots of articles talk about the need to provide BI and analysis on mobile devices. And lots of enterprise applications want to “mobilize” themselves. But I don’t see it. I don’t think employees want to do BI on a smartphone or even data mining on an iPad. Nor do they just want [...]

I did some work with Silverlink some time ago and was really impressed by their use of decision management to improve the communication of health plans and others in the healthcare space with members and patients. I got a chance to catch up with them recently to discuss progress and their use of adaptive control [...]

Insurance claims fraud is a huge deal, with most estimates seeing perhaps 10% of claims made being fraudulent – worth at least $30Bn/year. As a result the value of small improvement is huge. Of course, from my perspective, fraud is one of the classic uses of decision management and predictive analytics. Obviously the current economic [...]

Syndicated from ebizQ The first critical characteristic of a decision-centric organization, obviously enough, is a focus on decisions instead of processes or functions. The decisions an organization makes, the actions it selects from the possible alternatives are critical. Decisions are what make strategy real and drive results and performance against metrics. Implementing a strategy defined [...]

I got a chance to catch up with Andrea Allmon of FICO to hear about their new Insurance Fraud Manager release (3.0 in July). This is a timely topic because of the debates around healthcare at the moment. In all the discussions about healthcare costs you never hear about the amount of fraud involved, yet [...]

I am giving a tutorial and a presentation on putting predictive analytics to work at the forthcoming Predictive Analytics World show in Washington DC (October 20th-21st with tutorials on the 19th). I always like to illustrate my points with real examples and while I was preparing the presentation I had a chance to talk to [...]

I saw ServiceBench when I presented at the Warranty Chain Management Conference and got a chance to get a more detailed presentation just recently. ServiceBench is aimed at the Service Supply Chain and is now part of NEW (who also presented at the conference). The service supply chain is often very complex because of the [...]

Vision Service Plan, VSP, presented on their use of business rules to build agile business processes in healthcare. VSP has some 55M customers in their plans and have been an IBM/ILOG customer since 2002. Every process in healthcare is governed by policies, regulations – every process has decisions that must be made following the rules [...]

Warranty Week (Computer Warranty Trends, 26 March 2009) had an interesting article this week about the rising rate of warranty claims in computer companies: While other industries are seeing claim rates rise and accrual rates fall, warranty providers in the computer industry are seeing claims rise slightly and accruals rise a lot This prompted me [...]

Josh Becker of SubZero Wolf and Dave Froning of SAS presented on integrating text analytics and data analytics to make an impression. Text analytics has a lot of potential but success stories are not as widespread as you would think they should be nor are there many stories of operationalizing text analytics. The challenge, Dave [...]

Kevin Hogan of Accenture talked about how implementing a warranty system can drive harmonization and competitive advantage.  His focus was on a recent case where they helped a company implement an SAP-based Warranty solution. The case is a global heavy equipment manufacturer with about a focus on Europe and North America. They were running 4 [...]

Frank Kozlowski of Kohler presentedf on a web-based warranty system. When they set out to develop the system their goals were to move to a start-of-the-art, easy to use system that was web-based so dealers could enter claims directly anywhere in the world (they have 12,000 dealers). They wanted to reduce their cycle time from [...]

Jim Johnson of IBM gave IBM’s point of view on quality lifecycle management. Jim works in Global Services and works with auto and truck manufacturers. IBM’s research shows: That warranty reserves accrue at between 1% and 3% of sales and this is continuing to increase. Detection to correction cycles average over 100 days and can [...]

Doug Maddox discussed how Chrysler has worked on warranty waste and performance measures to help prevent and eliminate it. In the past, Chrysler had relied on Expense per Unit Repaired to monitor dealers but this was easily manipulated (high cost repairs could be hidden) and it drove adverse behaviors because dealers would refuse to perform [...]

Jeff Moore from General Electric and Greg Spraker from SAS (see my review of the SAS Warranty product here) spoke on using analytics to find and eliminate fraud in claims. GE’s appliance division dealt with paper claims prior to 2003 and randomly selecting claims for audit. Between 2003 and 2005 they increased the number of [...]

This is my presentation so there’s no blog about it. Here are my slides: Don’t forget to check out the white paper I have at decisionmanagementsolutions.com/warranty

Rob Pritchard of Infosys presented on the power of business rules in warranty. His focus is on agility – most warranty systems are inflexible and hard to change. Organizations cannot make changes to warranty policy to respond to competitors, can’t create what-if scenarios, can’t tighten claims control or pre-valid claims or repairs. These problems come [...]

Terry Adams of Ingersoll Rand, the parent company of Trane, presented on harnessing and coordinating warranty best practices. IR includes Trance, Thermo King, Schlage, Steelcraft and others for about $17B worldwide. All these acquisitions have experience and systems so Ingersoll Rand has a vision of a Business Operating System to drive common tools and methodology [...]

John Hagen of Trane presented on measuring and improving an effective and efficient warranty process. Trane produces Commercial HVAC systems of every size. Warranty is tricky because they make everything so specific to customers. Trane started a new quality initiative in 2004 because they felt that there were some low hanging fruit. They had warranty [...]