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Avrio Corporation Success Story
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The Los Angeles County Department of Personnel – Worker’s Compensation Division is a paper-intensive environment which requires staff to continuously review incoming medical bills, process claims, update information on legacy claims systems and answer inquiries regarding outstanding claims.
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The Problem
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LADOP Worker’s Compensation Division’s primary task is to process new claims received from city departments and bills received from medical providers. Other tasks include processing legal counsel pleadings, correspondence, vocational rehabilitation paperwork and utilization reviews. These processes are extremely paper-intensive, time-sensitive and subject to State Regulations for objections and payment due dates. Challenges inherent to the process include manually routing paper documents to multiple team members and external vendors, meeting due dates, creating and utilizing standard correspondence templates, managing and reassigning workloads and locating work items and documents.
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The Solution
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Avrio Corporation developed a worker’s compensation solution that resolves multiple challenges for the LADOP Worker’s Compensation Division. In creating the solution, Avrio used a proven workflow tool called eFlo to automate business processes and FileNet’s Content Services tools to enable document capture, storage and retrieval.
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Avrio was able to automate extensive list of processes for the LADOP Worker’s Compensation Division. Document scanning has replaced time-consuming manual processes such as time-stamping bill documents. Avrio’s workflow distribution and routing engine eliminated the manual distribution of work, automatically assigning new tasks to appropriate teams and calculating critical due dates. Automated systems actions route, pend and close tasks, further reducing manual processing requirements. In addition, external vendors can now access work by using Avrio’s thin client eFlo user interface, and document images and data can be exported directly into vendor medical bill review systems. Once bill review processes are completed, Avrio’s workflow tools import vendor evaluations of bill document images back into the system. Vendor evaluations are then matched it with appropriate work items, and routed to the bill payment team for processing.
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Outbound correspondence formats are standardized, and the overall communication process is enhanced with eFlo’s letter generation tools. These tools allow users to select MS Word letter templates and obtain input data from both legacy claim applications and eFLo work items in creating outbound correspondence. It also allows documents to be added to a FileNet Content Services repository, where they can be access for future reference. Finally, the management and tracking of work is facilitated using a grid control, which allows managers to view all outstanding and closed work items from a single view and group/sort items based on any field requirement.
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