Using Workflow for
Strategic Case
Management
Agenda
•
Document Management
•
Wait Period
•
Locate Process
•
Interstate Process
•
Enforcement Actions
•
Case Closure Process
•
Task Prioritization
Document Management
Comparison
LEGACY SYSTEM
1.
2.
Printing was done manually.
When a form is returned, users had to verify the
information manually.
CAMS SYSTEM
1.
2.
3.
Automated way of generating
forms/bundles of forms.
Track the inbound form using the unique
barcode.
Mark sense technology to take the next
appropriate action automatically.
Legacy System
Volume of mail-outs
generated annually
(Approximately)
Resources
CAMS System
4 Millions
6 Millions
(More
communication)
95 Members
15 Members(1/6th
of the team)
How Automation can be done?
Forms automation can be achieved by using below options.
Bar Code
Mark Sense
• Tracks Incoming and Outgoing forms
• Contains unique number to identify form
• Combination of Form version, client category, form code, and internally generated number
•
•
•
•
Used to fill specific data
Used for Change of Address
Selection of check box
Scan and track the incoming data on the form
Inbound
• Any mark sense form filled by user like address change that’s returned to the Client.
• Scanner reads the updated information and creates an inbound interface file.
Inserter
Marks
• Horizontal line to define start and end of single form. One horizontal line on all pages and two
horizontal lines on last physical page.
• Lines scanned by machine folding and packaging forms in envelope.
Barcode
Mark Sense
Inserter Marks
Forms used
Trigger
Source
Printing
Type
Transaction: Forms generated due to status change
of Transaction.
Online: Forms generated from a custom program .
•Individual
•Packet
• Simplex : Prints on only one side of the paper.
• Duplex : Prints on both sides of the paper.
• Mixed : Combination of simplex and duplex.
Forms will be printed at local or central printer.
Form Type
•Normal : Forms which are generated in the system.
•Images : Tiff files are considered as images
Grouping
•Individual : Single form is sent to the customers.
•Packet
: Two or more forms are grouped
together and sent to the customers.
•Normal
•Images
•Transaction
Grouping
Online
Form
Type
Printing
type
•Simplex
•Duplex
•Mixed
Wait Period
Comparison
LEGACY SYSTEM
1.
All the ‘Wait’ related items were manually
tracked by the Case workers.
CAMS SYSTEM
1.
2.
Specific number of days can be configured
in the system through ‘Wait Period’ in
CAMS system.
System can automatically trigger the
defined actions after the wait period is
over.
Use of ‘Wait Period’ in Case Creation Process
Public Assistance
Service Request
Collect
Critical Data
Process
CP/DP
Benefits
Yes
No
Program checks for
Benefits for 65 days
Benefits
Available
No CP/DP Benefits
Close Public
Assistance
Service Request
Creation of Case
Locate Process
Comparison
LEGACY SYSTEM
CAMS SYSTEM
An alert was created when the following information
was received
1. Employment and Wage Data
2. Address Data
3. Personal Information (SSN, DOB etc.)
4. Liquid Asset
1. Employment and wages are updated
automatically based on 50 rules.
2. Address is verified and updated
automatically based on 122 rules.
3. Personal data is verified and updated into
the system based on more than 50 rules.
4. Liquid Asset data is updated automatically
based on rules.
I/B and O/B
FTP SERVER
File 1
File 2
File 3
File 4
File N
External
agency files
SQL SERVER
PROCESSING
F
I
L
E
L
E
V
E
L
V
A
L
I
D
A
T
I
O
N
Ranks Table
(High/Med/Low for
each source)
Staging Tables
File(s)
Address
Employment
Personal Data
Rules
Engine
Load Program
Match flags
Reject flags
Update flags
Update Program
Address
Normalization
Automated Locate Process
Master Data
Interstate Process
Comparison
LEGACY SYSTEM
CAMS SYSTEM
•
•
Any CSENet request would result in an
alert.
•
•
•
Automated Transmittal 1/2/3.
Automated determination of CSENet states
based on FAR codes.
Location information through rules.
Automated reprocessing of erroneous
records.
CAMS
FAR
(Function
Action
Reason)
CSENet
Hub
T1
CSENet
File
FAR Based
Configuration
Tables
Staging Table
C
S
E
N
E
T
Create
Service
Request
Case
Create
CAMS Case
C
A
S
E
D
O
C
U
M
E
N
T
S
CSENet O/B
(Ack)
T2
Process
T3
Create
ZIQL
Update
Rules
Locate in
CAMS
Automatically
Updated
CSENet O/B
(Response)
Automated CSENet Inbound Process
Florida CAMS
CSENet O/B
(Ack)
CSENet O/B
-----------------CSENet O/B
(Response)
Changes on
Address/
Employment/
Personnel
-----------------Update
Rules
Changes on
Case
-----------------Changes on
Workflow
Data
from
Interstate
C
O
N
F
I
G
U
R
A
T
I
O
N
T
A
B
L
E
S
Electronic
Document
Automated
CSENet
Determine
Function
Action
Reason
Staging Tables
(Validation)
CSENet
Hub
State
Exception
Configuration
Printed
Forms
CAMS CSENet Outbound Process
Other States
Enforcement Actions
Comparison
LEGACY SYSTEM
CAMS SYSTEM
•
•
•
•
•
One day delay in Financial postings were
affecting Enforcement actions
Case attributes were not considered.
Manual Enforcement actions based on the
Segment
Enforcements hierarchy was not flexible.
•
•
Financial postings are synched everyday.
Combination of Payment behavior and
Segment drives enforcement actions
Highly configurable, so hierarchy can be
maintained without changing the actual
program
Automated Enforcement Functions
Payment and financial accounts
information from financial system
is posted
Medical
Compliance
NCP’s New
employment
1. Enforce
Health
Insurance
Compliance
Determination
2. Enforce NonCovered
Medical
Expenses
STOP
Income Deduction
Notice (IDN)
Compliant
YES
1.
Paper IDNs
2.
Electronic IDNS (eIWO)
3. Lapse of
Insurance
Changes
from Interface.
Ex: SSI Benefits,
TANF, Disability,
Unemployed,
Employed single Case
NO
Agencies Receiving Files
1. DHSMV
2. LSP
3. Credit Reporting Agency
Compliance Remedy Selection
Segment
1.
2.
Send Past Due Notices
Call for an interview
3.
4.
5.
6.
7.
Suspend Drivers license
Interstate Enforcement
Credit Reporting
Legal Referral
Personal property lien
Close the
Enforcements
Payments
Received?
NO
YES
Case Closure Process
Comparison – Case Closure
LEGACY SYSTEM
NEW CAMS SYSTEM
1. Closure reasons were set by the case workers
manually.
2. After the case is set to 'Evaluating closure' status,
case was manually being evaluated by the case
workers.
1. Almost all the federal case closure reasons are set
automatically by the system
2. System automatically moves the cases from
Evaluating to ‘Closed’ status.
Case Closure Process by Closure Reasons
Recipient Of Services
(Applicant) Requests
Closure
Determine New
Household Process
(Child No Longer Living
With CP )
Perform CP,
DP benefit
checks
Check if
Arrears are
more than
$500
N
Manage Unknown
Fathers Process
CP Deceased
N
Y
Y
Reopen the Case
Send out ‘Notice of
Intent to Close the
Case’ and wait for
60 days
Proceed with
Closure
Task Prioritization
•
Customized inbox showing all the assigned Tasks with the priorities.
•
Automated escalation of Tasks if not worked after certain number of days.
•
Automated way of assigning the Tasks to Workgroups based on availability.
Next steps…
•
Automated assignment of tasks based on Federal Performance Metrics.
Questions? Need More Information?
Feel free to contact us.
Jay Kumar
mrkumar@deloitte.com
850.339.9434