Rework and Re-rework Reduction - ASQ€¦ · Rework and Re-Rework Reduction ... Subject Matter...

1

© 2016 WIPRO LTD | WWW.WIPRO.COM 1

Rework and Re-rework Reduction - Expanding the Circle of Influence

Methodology: DMAIC

Claims Customer

Service


Understanding some terms GLO

a) Provider – A physician or hospital

b) CPA – Claim Payment accuracy measured by audits on transactions

c) DAR – Dollar Accuracy Rate measured by audits on transactions evaluating the accuracy

of dollar amount paid

d) BPQM – Business Process Quality Management program run by client to audit Wipro

processed transactions

e) NAN – No Adjustment Needed – Cases incorrectly transferred from the PPR (Customer

Service Team) where no Adjustment is required

f) PCRS – Provider Claims Resolution Specialist

g) CPH – Claims per hour, as a measure of productivity

h) PPR – Provider Phone Representative

i) HIPPA – Health Insurance Protection and Portability Act

j) CMS – Regulatory government body for Medicare and Medicaid claims

2


Section 1.0.0 Project and Team Selection


Understanding the Context of Project Selection

Strategies Data and

Dashboards

Business

Objectives

Funneling by

Brainstorming

Wipro Funneling Framework

Evaluation and Prioritization

Company Strategies

• Value Addition

• Improve client base

• Reduce Operating Costs

Client Strategies

• Cost Reduction

• Risk Reduction

• Better Value for Money

Vertical strategies

• Industry Re-Engineering

• Business Transformation

Vendor Dashboard Review

Monthly Business Reviews

Pareto for top defects

Audit and Survey Results

•Customer Value Index

•Customer Feedbacks

•Wipro Way

Customer Centricity

•Customer comments

•Value Addition Opportunities

Net Promoter

Score

•Evaluate Client CTQ

•Leverage Expertise for client objectives

Client Objectives

Allocation of Prioritized Projects

Process Level

• To improve working conditions

• To optimize current operating model

Client Level

• What means value to client

• Where do they need our assistance

Account Level

• What’s new in the industry

• Replication opportunities across the vertical

Quality Circles

Kaizen Events

Lean

Six Sigma

Management

Team

Champion

Master Black

Belt

Black Belt

Green Belt

Six Sigma

Kaizen Lean

1.1.1

3


Understanding the Context of Project Selection

1. Rework vs. Re-Rework

Analysis

2. Claim Lifecycle Analysis

3. CTQ Dependency Mapping

1. UHG – Wipro Rework Summit

2. Stakeholder Connect

3. UHG MBO

4. Connect with UHC Senior

Leadership

1. Domain Expert Connects

2. Leverage Industry Analytics

3. National Health Insurer

Report Card, AMA

4. Maintaining MLR Ratios

5. Cost per claim Analysis

Domain & Industry

Process Dynamics

Voice of Customer

Industry Connect

• Inaccurate Claim Processing resulting

into Rework and Re-Rework

• Low Output

• Hygiene and Compliance

• Bad Rework

Objectives Shared:

• Rework Reduction

• Re-Rework Reduction

• Drive Provider Experience

• Interest Reduction

• Provider Data Accuracy

Rework vs. Re-Rework Analysis:

• 14.59% of Rework moves back

into Re-Rework

• Rework Induced due to First Rework

Touch

• Rework Induced due to PPR

1.1.1


Project Selection Process 1.2.1

Sr.

Gaps /

Concerns

identified

PEX

Sponsors

Impact

to

Business

Client

Impact

Contractual

Obligation

Risk to

Business Input Source

Importance

Rating

1

Rework &

Re-rework

Reduction

Amrish S 3 3 2 3 Queue

Review -

Balanced

Scorecard

86%

High Kim Rudd 2 3 3 2

Prashant K 3 3 2 2

2 Interest

Reduction

Amrish S 1 2 1 2 Auto

Adjudicator

Defects

53%

Low Kim Rudd 2 2 1 2

Prashant K 1 2 1 2

3

Provider

Data

Accuracy

Amrish S 1 3 2 2 Volume

Study –

Balanced Sc

orecard

75%

Medium Kim Rudd 3 3 2 3

Prashant K 1 3 2 2

Quarterly Quality Summit

A – Process Door Review Approach >85 >70 <60 HIGH MEDIUM LOW

B – Data Door Review Approach Partial Illustration

Extract Actual data for shortlisted Gaps /

Concerns

Validate if the contractual targets

are met

Comparative study between queues and

lines of business

If target met, identify process

improvement target

If target not net – Identify RCA and fix

Gaps

4


Project Selection Process

Funnelling Exercise – Pareto Priority Index

Sr. No

Opportunity Of Improvement Savings p.a. Probability of Success Cost Time of Completion PPI (Pareto Priority

Index)

1 Rework and Re-Rework

Reduction $1,500,000 50% 14 FTE 6 months 8928

2 Reduction in Call Volume $750,000 50% 9 FTE 5 months 6944

3 Interest Reduction 2 $300,000 50% 8 FTE 5 months 3750

4 Provider Data Accuracy $200,000 50% 5 FTE 6 months 3333

5 DPIR Improvement $100,000 50% 5 FTE 4 months 2500

Voice of Business

Can we attempt integrated solutions to reduce the

cost of operations for UHG?

- Prashant Kulkarni

VP Operations Count 2604 841 331 117 102

Percent 65.2 21.1 8.3 2.9 2.6

Cum % 65.2 86.2 94.5 97.4 100.0

Re - Rework OtherRekeyTRSIRUPCRS

4000

3000

2000

1000

0

100

80

60

40

20

0

Pe

rce

nt

Pareto Chart of Re - Rework

Volumetric data shows higher impact

from PCRS

1.2.2


Problem Statement:

Historical data for last 15 weeks shows that the Defect

Proportion for the PCRS Queue stands at 0.00726 and

the NAN Ratio to the overall claims volume routed by

PPR to PCRS stands at 19.10%, hence cumulatively

impacting re-rework and generating Bad Rework.

The overall impact is to the tune of USD 0.76 Mn.

Project Benefits

1. Improved Accuracy and Efficiency

2. Re - Rework Reduction

3. Better Provider / Member Satisfaction

4. NAN Reduction

Goal Statement:

To transform the Provider Operations by reducing the

Defect Proportion to 0.004 and reducing the NAN % to

17.5% by 15th September 2015

Stakeholder / Customer Impact

1. Steven Garcia, Michelle Ferensic , Cheryl Fetherston

, Meghan Minton , Kim Rudd , Brian Smith & Fay

Payne

Improved Accuracy, Efficiency and Re-Rework

reduction

2. Scott Naasz, Matt Rowley & Michael Blaylock

Reduced NAN, Improved Efficiency and Synchronized

Research

Project Selection Process 1.2.3

5


Pega

(Provider

Portal)

PPR

(Provider

Calls)

PPL

(Provider

Portal)

Queue

(First Pass

Processor)

Ingenix

PCRS

Adjustment Adjustment

Required?

Additional

Info

Required?

Adjust the

Claim Route to IBP

No

Yes

NAN No

Yes

Close the ORS

END

• The PCRS Adjustment Team gets volumes from Pega, PPR, PPL,

First Pass and Ingenix

• The Business expectation – Process the Rework Inventory in a

flawless and timely manner

Team Selection and Preparation 1.3.1



Team /

Dept Skillsets Required

Nominated

Candidate

Process

knowledge

Ability to

Influence Bandwidth

Stakeholder

Rating Selected

Auto

Adjudication

Automation

1. Contract Loading

2. Benefits

Configuration

3. VB Coding

Kay P 8 5 7 +1 Yes

Donna

Badger 5 5 6 0 No

Predictive

Analytics

1. Error

Identification

protocol

2. Volume Selection

3. Business Rules

Kay P 8 5 7 +1 Yes

Dave F 8 7 2 0 No

Karen T 7 6 5 +1 Yes

Business

Partners

1. Nurse Reviews

2. Fraud and Abuse

Identification

Kim R

Karen T 6 6 3 0

Adhoc

Involvement

Wipro

Operations

+

Client

Operations

1. Claim

Adjudication

2. Medicaid and

Medicare

3. Contract and

Eligibility

4. AS400 and

UNET

Faiyaz Khan 7 6 7 +1 Yes

Aman D 6 5 6 +1 Yes

Saby C 6 7 4 -1 No

Brijesh S 7 7 7 +2 Yes

Zaheer A 7 7 7 +1 Yes

Kristie R 8 8 7 +2 Yes

Stakeholder Analysis

6



Project Specific Trainings:

• AS400 and SEIBEL Training for Wipro Project Members

• Defect Prediction and Business Rules Prioritization Overview

• UNET Platform Overview

Domain Trainings

• Green Belt Refresher Training for Identified Project Lead

• Yellow Belt and 7 QC Tools for all Team members PEX Trainings

Project Pre-Go Live Discussions:

1) Project Overview, Expectations and Goals shared with all team members

2) Individual alignment to US client contacts and Orientation meetings for both

teams

3) Project Governance Model – Overview and What to Expect

4) Project Success Bonus + Most Valued Contributor Award Declared

5) Anticipatory Challenges identified and expectations set with project Sponsors



Sr No Team Member Specialization Responsibilities Assigned

1 Kay Pulley

1. Subject Matter Expert – Auto Adjudication

2. Subject Matter Expert – Error Prediction

3. Subject Matter Expert – HealthCare

System Coding

a) Support Auto Analytics

b) Support analytics and data provisioning

2 Brian Smith 1. Business Manager – PCRS a) Validate Analysis and Remediation

b) Onshore Deployment

3 Kim R 1. Sr. Business Manager – Partner Sites

2. Offshore Vendor Manager

a) Liaison with business Partners

b) Drive activities to be deployed at BP

4 Brijesh Singh

1. Operations Manager

2. Subject Matter Expert – Claim Adjudication

3. Subject Matter Expert – Claim Workflow

a) Project Lead and Program Manager

b) Empower and Drive project Members

c) Analytics and Remediation Deployment

5 Faiyaz Khan

1. QA/QC Manager

2. Subject Matter Expert – Manual Claim

processing

a) Data Provisioning

b) QA/QC Support for improving Accuracy

c) Subject matter Inputs for Domain issues

6 Matt Rowley 1. Business Manager – Provider Services

a) Project Sponsor and Steering Personnel

b) Review viability of analysis and actions

onshore

8 Aman D 1. Subject Matter Expert – HealthCare

System Coding (Wipro)

a) System Review + Support Analytics

b) SPOC for connect with Kay

9 Ratnesh D &

Debanjan G 1. PCRS Team Supervisor & SME

a) Deployment of actions across shop floor

b) Floor Communication

Pre-Golive Responsibilities Assigned and Communicated to team Members

7



Sr No Dept Data Collection Team Member Deadline

1 Auto Adjudication 1. Auto Fallout Data Collection Kay Pulley 31st May 2013

2 Predictive Analytics

1. Last 6 months data for Claims having highest

prediction of Error

2. Identified Claims with highest defect rate

Karen T 31st May 2013

3 Provider Services 1. Dump of all NANs

2. Description of all NAN Defects Matt R 31st May 2013

4 Business Partners 1. Repository of Contractual TAT for different

claim types Kim R 31st May 2013

5 Wipro Operations

1. Productivity Dumps for 3 months

2. Claim type Bifurcation

3. Audit Accuracy Reports for 3 months

4. Adherence Reports

5. Shrinkage and Attrition data

Faiyaz 22nd May 2013

6 Client Operations

1. System Downtime and Latency reports

2. Claim Forecast – month on month for last 3

months and further 6 months

3. Onshore Productivity and Audit Accuracy

Dumps

Brian Smith 31st May 2013

Preliminary Data Collection Plan

A. Weekly Connect Meetings planned with the project team – Onshore and

Offshore

B. Bi-Monthly Reviews with Champion and Black Belt

C. Monthly Project Reviews with client

D. Tollgate with all stakeholders and Steering Committee & Sponsors

Define 1-May-15

Measure 10-May-15

Analyze 5-June-15

Improve 15-July-15

Control 15-Sep-15


Section 2.0.0 Current Situation and Root Cause / Improvement Opportunity Analysis

8


Provider Satisfaction

Accurate Claim

Processing

Payment Integrity

Overall Accuracy Rate

Business Growth Compliance Cost Reduction

Rework

Reduction Provider

Satisfaction

Claims per Hour

Client Satisfaction Cost Reduction Higher Efficiency All Green Scorecard

Claim Processing

Efficiency

Hygiene & Compliance Turn

Around

Time

Rework

ReductionRe – Rework

Reduction NAN

SIPOC

Review

Business CTQ

Customer CTQ

Internal CTQ

Project CTQ

Operational Definition of Project CTQ:

Defect Proportion = Total Defects

Total Client Audits

S n

Where n is the number of metrics

NAN% = Proportion of NAN vs. Total PPR Claims Volume

routed to PCRS

Key Measures Expected of the Project 2.1.1


• PCRS + PPR Queue

Lateral

• Start: Start of the shift

• End: End of the shift

Longitudinal

Outside Scope

1st Pass, Other Rework Queues,

Government services

Operational Definition of Project CTQ:

Defect Proportion = Total Defects

Total Client Audits

S n

Where n is the number of metrics

Measurement system Analysis

Observations:

% Contribution < 10%

No. of Distinct Categories > 4

NAN% = Proportion of NAN vs. Total PPR Claims Volume

routed to PCRS

Key Measures Expected of the Project 2.1.1

9


Possible Root Causes / Improvement Opportunities 2.2.1

• Review available data trends to evaluate the cause as an impacting X

• Probable Causes – No Validation Required and No Cost Implementation

• Brainstorming – Probable Cause Generation

• Identify & classify potential causes

• Evaluate process inputs and outputs

• Evaluate Decision Processes for all Cluster Y SIPOC

& Detail Process Study

Probable Cause

Generation

Evaluate potential

cause data

Quick-Wins

3 Strata of population was used to identify potential causes

• Low Tenure

• High tenure

• Support Staff

All project Team Members Coached on executing Brainstorming sessions and recording points of

discussion


Quick wins

Validation

Rejected

44 X’s

3 Quick Wins 41 X’s

2 Uncontrollable 39 X’s

Defect Rate

1 Repeat 38 X’s

Analysis

Sr Description of X Quickwins Implemented Effectiveness Check Status

1 Timely Support Availability

Acting SME Concept in absence of SME + Floor Walker opportunity to top

performers BB Dipsticks Ongoing

QA to support respective alignments in absence of SME BB Dipsticks Ongoing

2 Trainer and SME Calibration Trainer and SME calibration initiated with Onshore SME as the master

calibrator BB Dipsticks Ongoing

3 Within Auditor Calibration Within Auditor Calibration initiated with QA Lead as the master

calibrator BB Dipsticks Ongoing

Possible Root Causes / Improvement Opportunities 2.2.2

http://www.google.co.in/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=pYdayKfXCv1TZM&tbnid=jvbeeGuJ0VDrVM:&ved=0CAUQjRw&url=http://freelanceswitch.com/freelance-marketing/whats-in-your-sales-funnel/&ei=Z5YoUrLEIJDrrAf2hoCgDQ&bvm=bv.51773540,d.bmk&psig=AFQjCNE0YndAgou3W5RU1nd2Mk13Nr5gmw&ust=1378477989647800

10


• Sample Size = 15 weeks @ 95% confidence Level

• Capability Analysis was conducted for Defect Proportion

• One Data Point beyond control limits

• DPMO = 7255

• Zst = 3.94

Capability Analysis:

Target Setting

STATISTICAL PROBLEM:

Null Hypothesis (Ho): Defect Proportion for PCRS is less

than or equal to 0.004 [μ <= 0.004]

Alternative Hypothesis (Ha): Defect Proportion for PCRS

is > than 0.004 [μ > 0.004]

INTERPRETATION:

The P-Value is < 0.05. Hence we reject the Null

Hypothesis.

Any target lesser than 0.004253 is a statistically

significant target for this project

Final Root Causes / Improvement Opportunities (PCRS) 2.3.1


• Sample Size = 10 weeks @ 95% confidence Level

• Continuous Data: Normality Plot

– As p > 0.05, the data is normal

• Continuous Data: Run chart and Control Chart

– Data was found to be random, As p > 0.05 for Trends,

Oscillations, Mixtures and Clustering

– Control chart was plotted, which shows that the data is in control

• Capability Analysis was conducted for NAN%

– Zst = 0.54

Zst = 0.54

Data Analysis – Normality Test and stability check:

• Any target less than 18.15% is a statistically

significant target for NAN %

Final Root Causes / Improvement Opportunities (PPR) 2.3.1

11


Final Root Causes / Improvement Opportunities 2.3.1

Factor

Statistical : Correlation,

Regression Analysis

Graphic: Scatter

diagram

Res

po

nse

X

Y

Statistical: Mean- t- test,

ANOVA, Variance- 2-

Variance test, Test for

Equal Variances

Graphic: Mean-

Histogram, Variance-

Box- plot

Statistical: Logistic

Regression Analysis

Statistical: 1-proportion,

2-proportion, Chi- Square

test

Graphic: Pareto chart,

Data Visualization

(Tableau)

Continuous Discrete

Con

tin

uou

s D

iscr

ete

Data Analysis Based on Data Type


Final Root Causes / Improvement Opportunities

• P001, B004 and K002 error codes are the top contributors for the Procedural

error type

• I016, B004 and L001 error codes are the top contributors for the Financial error

type

2.3.2

12


• Audits done on the various errors to segregate the errors into conceptual and

negligence

• These error codes were further segregated into the error type

• Conceptual error contribution is higher compared to negligence



• Error code wise Mispaid amount analyzed to determine which error type is

contributing to higher financial impact to the customer

• L006, N001,B004,L025, 1018 and 1016 are the Top errors contributing to the

Financial Mispaid amount


13


• Agent wise contribution to errors analyzed to understand the outliers.

• These were further bifurcated into Financial and Procedural to understand which

error type is contributed by which agent.



Statement Statistical Problem Statistical Tool Conclusion

X 22: Productivity impacts Overall

Defect Rate

Ho: Overall Defect Rate is

independent of Productivity

Ha: Productivity has a significant

impact on Overall Defect

Rare

Correlation

P Value > 0.05 and the Pearson correlation

value is insignificant, hence there is

no Correlation between Productivity

and Overall Defect Rate

• Although Productivity does not Impact the

Defect Proportion Statistically, it is not

meeting the desired goal of 5.4 OPH

• As per advise from Champion and LBB,

Solutions to be designed for proportion

defective, however do attempt improvement

in productivity if possible through same set

of solutions


14



X 23: Day of the Week impacts

Overall Defect Rate

Ho: Overall Defect Rate is

independent of Day of the

Week

Ha: Type of Error has a significant

impact on Overall Defect

Proportion

Moods Median Test

P Value > 0.05 hence Day of the week does

not impact Defect Rate

The P Value > 0.05 which signifies that we accept

the Null Hypothesis

Day of the Week does not impact the Overall

Defect Rate


X11: Impact of Processor Tenurity

on Defect Proportion

Ho: Defect Proportion is

independent of Processor

Tenure

Ha: Agent Tenure has a significant

impact on Defect Proportion

Kruskal Wallis Test

P > 0.05; Agent Tenurity has no impact on

the Defect Proportion

The P Value > 0.05 which signifies that we accept

the Null Hypothesis

Processor Tenurity does not impact the Overall

Defect Rate



Comparative Assessment


Comparative Assessment : PPR vs PCRS

Validate the accuracy of Non Adjust

Determination by the PCRS and

PPR Teams when assessing the

same units

Discriminant Analysis

Significant deviation exists in Interpretation of

adjustment when comparing PPR vs PCRS

• The proportion correct enumerates that the overall estimation of AIN, NAN and PEN

put together when assessed by PPR and PCRS is trending at 69.2%

• Considering Non Adjust Rate only, the proportion of synchronized assessment is

67.6% indicating potential lacuna in evaluation due to :

• Training

• Research Methodologies

• SOP Conflicts

15



X25 to 39 Type of error impacts

NAN %

Ho: Overall NAN% is independent

of Type of Error

Ha: Type of Error has a

significant impact on NAN%

Pareto

Audit Data Considered

Basis the error contribution the highlighted

NAN errors have a significant impact

on the NAN %




X25 to 39 Type of error impacts

NAN %

Ho: Overall NAN% is independent

of Type of Error

Ha: Type of Error has a

significant impact on NAN%

Pareto

Audit Data Considered

Basis the error contribution the highlighted

NAN errors have a significant impact

on the NAN %


16


X Identified Xs Validated (Y/N) Statistical Tools Used

1 Assistance surgeon incorrect Y

Tableau Analytics

2 Adjustment Not Completed Y

3 Interest Penalty Error N

4 Suspect Duplicate Denied Incorrectly Y

5 Out-of-network paid in-network Y

6 Co-surgeon Incorrect Y

7 Co-insurance Error Y

8 Orate/Outpatient contract calculated incorrectly Y

9 Anesthesia Incorrect Y

10 History Research Error Y

11 Multiple Therapy Reduction N

12 Incorrect FN Denial Y

13 Duplicate Charges Paid Y

14 Authorization/Notification selection incorrect Y

15 Schedule Amount Error Y

16 Corrected Claim/Late Charges mishandled Y

17 Incorrect remark code used N

18 OOP Calculation Incorrect Y

19 Incorrect Provider Suffix N

20 Negotiated amount incorrectly applied Y

21 Conceptual vs. Negligence Y

22 Impact of Productivity N Correlation

23 Day of the Week N Moods Median

24 Processor Tenurity N Kruskal Wallis



X Identified Xs Validated (Y/N) Statistical Tools Used

25 14 DENIAL Related Y

Pareto

26 Add on Policy Related Y

27 Allowable Conflict Related Y

28 Claim Already Processed N

29 Copay Related N

30 Coverage Related N

31 Deductible Related N

32 Global Day Policy Y

33 Medicare Related N

34 Notification Related Y

35 Other Insurance Related N

36 Therapy Related N

37 Timely Filing Related Y

38 COB Related N


17



1. Toll gate review scheduled with the Steering Committee, Sponsors and stakeholders

2. All identified root causes shared with the reviewing team

3. Process Door based Review - Stakeholders were asked to cast votes for root causes that were found

relevant considering process Knowledge

RCA Stakeholder

1

Stakeholder

2

Stakeholder

3

Stakeholder

4 Specific Comments

Defect Type RCA for

PCRS 9 9 8 9

The Top Defects are resulting

in Re-Rework

Defect Type Analysis for

PPR 7 6 7 7

PPR Errors are Impacting the

overall NAN

Data Door approach:

To validate final root causes

• Shadowing sessions by Quality Auditors

• Sample based study to validate impact

Focused sample helped validate the impact identified from statistical validation was significant


Project management update 2.4.1

Program Management

Tollgate Reviews

Weekly MIS for Progress

Client inputs

Progress review at all locations /

sites

Validation of Correctness in Initial Scoping,

Deliverables and Timing

Initial Project Scope:

• Active involvement of Black Belt and

Champion in data collection

• Weekly review of data sanctity and

relevance - CUIKA

• Initial scope also included Auto

Adjudication Team and their data, however

no relevance to project goal observed post

data collection

• Team composition changed

Stakeholder Involvement and Communication

• QIC meeting involving

• Program manager from each stakeholder groups

• Champion

• Black Belt, Green Belt and project Team

• Governance Framework defined for review of effectiveness

• QIC minutes + Project MIS shared with all stakeholders

• One on One connect with stakeholders who do not attend QIC due to other commitments

Governance Model

18



Stakeholder Resistance:

Appropriateness of Team members

• Appraisal of all team members based on responsibilities assigned v/s tasks executed – Monthly ratings

• Appraisal conducted by BB, GB, Champion and the project sponsor

• All team members reviewed basis 2 categories

• G Ratings – Performance on goals / responsibilities assigned

• P Ratings – Personal Effectiveness in execution of tasks assigned

• G/P 1 – More contribution Expected

• G/P 2 – Needs Improvement

• G/P 3 – Highly Valued Contribution

• G/P 4 – Exceeds Contribution

• G/P 5 – Significantly Exceeds Contribution

• Any team member graded 1 or 2 would be replaced. This project had all >= 3 as ratings

Stakeholder Team Resistance encountered Resolution provided

Auto Adjudication

Removed from the scope and

hence all data collection efforts

wasted; Unrest during meetings

Set appropriate expectations in

presence of HOD for Auto

Adjudication team

Operations Team

Involvement of Floor SME in

project studies unavailable due to

higher attrition in 1 month (loss to

competition), hence all hands on

deck

2 Top performing SME identified

and Overtime paid for 2 weeks to

keep project on track


Section 3.0.0 Solution / Improvement Development

19


Possible Solutions or Improvements 3.1.1

Brainstorm to Create a repository of possible solutions

Impact Analysis for

each solution

Cost Benefit

Analysis + Contractual

Study

Solution Selection Matrix - Prioritize

Go/No Go

Wipro Solution

Generation model

Brainstorming and Creative Thinking

Evaluate Impact on X

Target System 1st and then

employees

Possible Automations

(Wishful Thinking)

Evaluate Impact on Y

Idea Generation at all levels of

hierarchy

Tools Used

Proceed to Prioritization

Go

No-GO

?

What are the Costs

involved to

implement?

What is the

corresponding

Benefit?

When do we

Breakeven?

Are the costs

acceptable?

Additional Teams Involved:

Client Onshore SME and Processors involved for Idea generation

Business Finance Team for Cost and Benefit Estimation

Business and Billing Model coaching provided to Project Lead


Validated X Actions Impact on Y Cost Estimate Benefits Expected Within

Control Go / No Go

- Assistance surgeon incorrect

Assess elimination of manual

intervention 3% 1 FTE 3 FTE Yes Go

Auto Calculation of Assistant

Surgeon Benefit 3% 2 FTE 3 FTE Yes Go

Increase Sample Size for Audits 2% 8 FTE 3 FTE Yes No Go

- Adjustment Not Completed

- Schedule amount Error

- Negotiated amount incorrectly applied

- Orate/Outpatient contract calculated

incorrectly

- Anesthesia Incorrect

- OOP Calculation Error

Assess elimination of Manual

Intervention 22% 2 FTE 8 FTE Yes Go

Auto Calculation of UB / HCFA

Allowable 22% 5 FTE 8 FTE Yes Go

Refresher Sessions 8% 8 FTE 3 FTE Yes No Go

- Suspect Duplicate Denied Incorrectly

- Corrected Claim/Late Charges

mishandled

- Duplicate Charges Paid

Assess elimination of manual ORS

to ICN search 17% 2 FTE 6 FTE Yes Go

Auto ORS search for a particular

ICN 17% 3 FTE 6 FTE Yes Go

Increase Sample Size for Audits 9% 5 FTE 3 FTE Yes No Go

- Authorization/Notification selection

incorrect

- Co-insurance Error

- Out-of-network paid in-network


Research 14% 2 FTE 5 FTE Yes Go

Auto Determination of the

applicability of RAPS/Noblx 14% 3 FTE 5 FTE Yes Go

Re - Training on Research and

Other Top Errors 7% 8 FTE 3 FTE Yes No Go


http://adabisnis-pns.com/wp-content/uploads/2010/08/creative-thinking.jpg

20


Validated X Actions Impact on Y Cost Estimate Benefits Expected Within Control Go / No Go

- Multiple Therapy

Reduction


Research and Determination 9% 1 FTE 4 FTE Yes Go

Auto Determine the Ranking of the

Applicable Codes 9% 2 FTE 4 FTE Yes Go

Re - Training on Research and Other

Top Errors 3% 4 FTE 2 FTE Yes No Go

- History Research Error



Refresher Sessions and Coaching 4% 2 FTE 3 FTE Yes Go



- Incorrect FN Denial


intervention 6% 1 FTE 4 FTE Yes Go

Auto Determination if an electronic

referral is required to see a specialist

from the Primary Care Physician

6% 2 FTE 4 FTE Yes Go



- Co-surgeon Incorrect



Auto calculation of the co-surgeon

benefit 6% 2 FTE 3 FTE Yes Go





Validated X Actions Impact on Y Cost Estimate Benefits

Expected

Within

Control

Go / No

Go

-14 DENIAL Related

-Ad on Policy Related

-Allowable Conflict Related

-Global Day Policy

-Notification Related

-Timely Filing Related

Assess elimination of

manual intervention 54% 2 FTE 10 FTE Yes Go

Auto Research Functionality 54% 5 FTE 10 FTE Yes Go

Refresher Sessions 12% 10 FTE 6 FTE Yes No Go

SOP Calibration 40% 5 FTE 5 FTE Yes Go

Increase Sample Size for

Audits 10% 8 FTE 3 FTE Yes No Go

Assistant

Surgeon

Tool

FN Denial

Tool

History

Search

Tool

ORS

Search

Tool

Co –

Surgeon

Tool

Benefit

Determina

tion

Tool

Allowable

calculation

Tool

Code

Ranking

Tool

Policy

Research

Tool

Individual Macros / Tools

High propensity of manual

errors

Logistic & Maintenance

Challenges

No Centralized tracking on

usage

Human Miss-outs


21


Final Solutions or Improvements 3.2.1

Shortlisted Action Plans Verified by Operations

Verified by Onshore Ops

Verified by Systems Team

Verified by Predictive Team

Consider for Final Deployment

Assess elimination of manual Research and Determination

Yes Yes Yes Neutral Yes

Auto Calculation of various types of Benefits and Allowables

Yes Yes Yes Neutral Yes

Assess elimination of manual ORS to ICN search

Yes Neutral Neutral Neutral Evaluate key

Functionality only

Automation of Research Steps

Neutral Yes Neutral Neutral Evaluate key

Functionality only

SOP Calibration Yes Yes Neutral Neutral Yes

Refresher Sessions, Coaching and Assessments for Mycoach and KL

Yes Yes Neutral Neutral Include - Monthly

Coaching Plan

Tool / Methods used – Multi-voting, Cost Analysis and Anticipatory Failure Determination

Team readiness – Methods included in 7 QC training imparted to all team members, UAT Testing,

Collaborative Working

Reason for Usage – Multi – Dimensional teams and multiple dependency requires to get buy in from all

stakeholders in presence of entire project management group


Rework GUI

+

Robotics

Rework GUI

+

Refresher

Sessions

Rework GUI

+

Robotics

Accuracy Efficiency Hygiene

Automated

Research

+

SOP Calibration

Bad Rework Synchronize Decision Making

Reduce Dependency on Labor

First Time Right

Mistake Proof Errors

Wastes Impacting Rework • Processing Errors resulting in Re-Rework

• Low Efficiency

• Hygiene Issues – Inappropriate Routes

• Bad Rework (NAN)

$ AI

!

PCRS + PPR Collaboration


22



A) Validation of Final Solutions:

1. A Pilot team was formed comprising of 11 members in Wipro and 5 members in client location

2. All 16 employees were coached on the revised processes and tools to be developed

3. A prototype of the tool was developed which covered 40% of the volume in the queue

4. Post validation of functionality and results, expansion of prototype was chalked out

5. POC continued for 2 weeks with the tools upgrading from v1 to v3

B) Evidence of validation:

A) Launch of Kaizen Event:

1. Kaizen Event launched to suggest too optimization

2. Expansion of tools to 100% Volume

Wipro Team 1 Wipro Team 2 Wipro Team 3 Wipro Team 4 Client Team 1

3 FTE 3 FTE 2 FTE 3 FTE 5 FTE

Performance of Pilot Team Baseline Post

Implementation

Defect Proportion 0.0084 0.0058

NAN% 19.8% 15.7%



Case

Installation+

Data Entry

Auto

Adjudication

Manual 1st

Pass Claim

processing

Predictive

Modeling

Claims

Resolution

Queue

Business

Partner

Review

Contract /

Notification

Review

Barcode

Technology +

Re-Router Droid

Barcode

Technology +

Re-Router Droid

Additional Potential benefits:

1) Re-Router Droid and Barcode Technology deployed for reducing

routing defects and multiple touch

2) Considering that the deployment is done at inception of claim in the

system; claims would be auto – routed to right Business partner,

benefiting

• Rework reduction in onshore centers

• Productivity enhancement in client onshore centers

• Member / Provider Resolution Time; TAT should exceed 70%

target

• Reduced transactional costing due to First Time right touch;

Expected benefit – USD 850,000

http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=hhCHv9s29MQvXM&tbnid=Yz31yASrEy6AcM:&ved=0CAgQjRwwAA&url=http://www.claimsjournal.com/news/national/2013/08/22/235294.htm&ei=dTtJUvnFJIiA9gTlkoCgDg&psig=AFQjCNHrfW_u0djluRAeEx2xwJz0NHRDig&ust=1380617461667140

23



Proof of Concept O/P

• Display Resolution related

• Covers only 78% volume

• Latency Issues

• Manual / Provider SPI to be included

Proof of Concept

• Improvement realized across the Pilot group

• Flaws and Defects identified

• Rectification of defects

Kaizen Event - Focus

• Continuous Improvement in the tool basis suggestions across stakeholder groups

• Enhancements and expansions

Final Release v5.5

• Solutions cover 100% Volume

• Testing expanded to 40 FTE

• Significant improvement across pilot groups

• Client Signoff

Amazing Robotics. The New GUI helps processors

work out of a single screen.

The Research Automation works Wonders

Thank you,

Kim Rudd

Performance of

Pilot Group

Performance of

Pilot Team

Baseline Post

Impleme

ntation

Defect Proportion 0.0084 0.0058

NAN% 19.8% 15.7%



Stakeholder Resistance:

Appropriateness of Team members

• Appraisal of all team members based on responsibilities assigned v/s tasks executed – Monthly ratings

• Appraisal conducted by BB, GB, Champion and the project sponsor

• All team members reviewed basis 2 categories

• G Ratings – Performance on goals / responsibilities assigned

• P Ratings – Personal Effectiveness in execution of tasks assigned

• G/P 1 – More contribution Expected

• G/P 2 – Needs Improvement

• G/P 3 – Highly Valued Contribution

• G/P 4 – Exceeds Contribution

• G/P 5 – Significantly Exceeds Contribution

• Any team member graded 1 or 2 would be replaced. This project had all >= 3 as ratings

Stakeholder Team Resistance encountered Resolution provided

Onshore Operations Team

Provisioning dedicated time from the

development team for automating

processes

Hired a VB developer in India and

aligned with SME for development

Business Finance Team

Hiring a VB professional resulted in

additional cost of manpower – Not

approved by Corporate Finance

Hired the resource and attributed the

cost to Operations, which was

recovered by coding processes that

could optimize productivity

Mailroom Services Lack of available workflows to

accommodate changes

BPMS approach adopted; Adopted

OCR / QR code as a solution for

ease of system changes

24


Section 4.0.0 Implementation and Results Verification


Stakeholders Considerations in Implementation 4.1.1

Stakeholder Role in Solution Selection Needs Met

Wipro and Client

Operations Team

1. Assist in solution generation

2. Evaluate viability of solutions

using Cost Benefit analysis

3. Prioritizing Final Solutions using

Criteria Matrix

4. Development & Reviewing of

automation scripts

5. Implementation of solutions

1. List of final solutions and

levers that could improve

quality

2. Partnership with client to

deploy the tool pan

enterprise

3. Regular feedback and

Kaizen Event deployment

Business Finance 1. Conduct Cost and benefit

Evaluation

2. Evaluate viability of solutions

using Cost Benefit analysis

3. Prioritizing Final Solutions using

Criteria Matrix

1. Cost of tool development

partially mitigated

2. Hardware costs eliminated

by deployment and

development on client

servers

3. IP rights retained

Application Development

Team

Feasibility analysis and

Development of any automations

for improvement

1. Testing on client servers

Steering Committee Same as Operations Team and

additionally

Tollgate Reviews and approval

1. Quicker Break Even

2. Client Satisfaction and

partnership

Client Leadership Team 1. Review of counter measures

short listed

2. Deployment approvals and UAT

3. Toll gate reviews

4. Onshore implementation

1. Business Model

Optimization

2. Signoff on benefits realized

3. Advocate solution developed

across Provider resolution

queues in US centres

25



Resistance Anticipation:

1) Force Field Analysis Used to evaluate the possible resistance that may be encountered for each

counter measure planned

2) The List of probable resistance was shared with the Champion and Sponsors to ensure calibration

Change

Proposa

l Forces Favouring Change Forces against Change

Pro

cesses A

uto

mati

on

1) IRM Team may reject deployment without

code review and following Risk management

procedures – ETA 2-3 months

2) Systems Team would block the execution of

tool to avoid any possibilities of latency

1) Reduction of processor Effort – Operations

Team

2) Elimination of Manual intervention

3) Expansion of automated logic to other

Rework Queues

1) Auto Routing of Appeals and Correspondence

to right agent

2) Reduction of triaging activities

3) Reduction of Multiple touch

1) Mailroom services – Resistance to Change in

their systems post introducing Barcodes

2) Lack of Accountability by the systems team -

extra coding work in the systems

3) Providers may resist making changes to the

form submissions

Barc

od

e/ Q

R C

od

ing

for

Pro

vid

er

Co

rresp

on

den

ce

Illustrative Sample of Force

Field Analysis



Resistance Encountered:

1) All resistance encountered during the implementation of solutions documented

2) Review of all 5 resistances encountered discussed with individual stakeholders and sponsors

3) Mitigation plan finalized by means of One on one discussions or enabling systems for resolution of

conflict

Resistance

type

Resistance

Anticipated Resistance encountered Identified – How?

Corporate

Systems – IT Yes

.EXE blocked on Citrix for execution. This impacts

deployment of executable and initiating the tool

Identified during the POC

phase when pasting .exe

gave an error

Automation -

Risk and

Compliance

No Finalizing the claim was prohibited by the risk team When the prototype was

submitted, kickback received

Onshore

Operations

Team

Yes

The tool resolution goes to 1280 x 1024 which

resulted in many processors refusing to use – Vision

Issues

Onshore Pilot deployment

Business

Finance Yes

Hiring of a VB resource for completing tool

expansion

Kaizen Event

Implementation

Contract

Loading –

Acceptance

Yes Contract loading team being defensive of defects

which were due to contracts incorrectly loaded

Lack of counter measure

acceptance in Project

Governance Meets

26



Resistance type Resistance encountered Resolution

Corporate

Systems – IT

.EXE blocked on Citrix for execution. This

impacts deployment of executable and

initiating the tool

1) Re-coded resource intensive scripts in VBA and

applets instead of VB

2) Code reviews and exception signoff with client VP –

Business

Automation - Risk

and Compliance

Finalizing the claim was prohibited by the

risk team

1) Considering CMS guidelines and Penalties, finalization

of claims removed from the automation

2) Claim is readied by the tool but the last finalization is

only post a processor reviews quickly and finalizes

Onshore

Operations Team

The tool resolution goes to 1280 x 1024

which resulted in many processors

refusing to use – Vision Issues

Tool aesthetics fixed in v2.0

Business Finance Hiring of a VB resource for completing tool

expansion

1) Exception request raised to CXO

2) Approval procured

Contract Loading

– Acceptance

Contract loading team being defensive of

defects which were due to contracts

incorrectly loaded

1) One on One discussion with stakeholders and

business review with the VP – Operations

2) Impact analysis shared with Contract installation Team

3) Reverse SLA created to ensure adherence and

accuracy

Mitigation of Resistance:

Measure of Resolution:

All activities back on track as per schedule

Brown Bag sessions conducted with all teams with resistance, All OK as their concerns were resolved /

mitigated

Maker – Checker Mechanism



Weekly meetings with all stakeholders for reviewing departmental reports

Data based Deliverable review – Revenue, Costs, CPM, Implementations for each phase

Signoff on findings and way ahead

Collaboration between IT and Operations for better buy-in

Restricted the Business Finance interaction with Steering Committee to the Tollgate meetings

All actions and project plan was regularly reviewed and signed off by Steering Committee and other stakeholders

Cost Benefit analysis further aided buy-in on solutions prioritized

Email based approvals from all stakeholders documented

27


Solution / Improvement Implementation

Policy Research

Robot

Co – Surgeon

Robot

FN Denial Robot Code Ranking

Robot

Benefit Determination

Robot

Assistant Surgeon

Robot

Allowable calculation

Robot

History Search

Robot

4.2.1


The Rework GUI is a Graphical User Interphase for the UNET Platform with Embedded Robotics to Assist a Processor to Adjudicate the Claim in an Accurate and Efficient Manner

Solution / Improvement Implementation 4.2.1

https://www.google.com.ph/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJGryOGQncgCFZEcjgodDo4PfA&url=https://wallpapers99.com/3D_Robot/1024x768-20942.htm&bvm=bv.103627116,d.c2E&psig=AFQjCNEsrGVrkTSRW3-h_lHf0LcLmadpjg&ust=1443646492219803

28

© 2016 WIPRO LTD | WWW.WIPRO.COM | INTERNAL 55

Robotic Solution Time Spent in Manual

Processing Time Spent in Rework GUI %age Impact

RAPS/NOBLX – The “Raps Noblx” Robot enables the user to automatically check/research whether the Raps or Noblx applies in the claim.

> 300 Secs <35 Secs 88.33%

UB Allowable – The Robot auto calculates the allowable of the Facility Inpatient or Outpatient claims

120 to 160 Secs <20 Secs 83.33%

HCFA Allowable – The Robot auto calculates various types of Physician Claim allowable using NDB Fee, MNRP Fee and R & C allowable.

120 to 180 Secs <20 Secs 83.33%

Consulting Physician – The consulting physician benefit determination and calculation is done automatically on a click of a button and eradicates research time.

190 to 220 Secs < 30 Secs 84.21%

MTR (Multiple Therapy Reduction) – The Robot auto determines the ranking of the applicable codes as per the Multiple Therapy Reduction and also make the necessary changes in the allowable of the codes according to rankings.

> 300 Secs <40 Secs 86.67%

Assistant Surgeon – Assistant surgeon benefit calculation has been automated through this robotic solution

90 to 120 Secs <30 Secs 66.67%


Embedded Robotics 4.2.1


Robotic Solution Time Spent in Manual

Processing Time Spent in Rework GUI %age Impact

FN Denial – The Robot auto researches whether the electronic referral is required to see a specialist from the Primary Care Physician.

> 180 Secs <40 Secs 77.78%

Co-Surgeon – Auto calculation of the co-surgeon benefit which is applicable in a claim as per the inbuilt logic.

120 to 160 Secs <30 Secs 75%

Filtered History ORS – History ORS plays a pivotal role in claim action determination. The Robot provides visibility to all the related ORS to a particular ICN can be gathered with a click of a button.

240 to 300 Secs <50 Secs 79.17%

Surgical Assistant – Surgical Assistant benefit determination which involved complicated calculations has been completely automated by this Robot.

60 to 80 Secs <30 Secs 50%

Purged HX Search – The Robot has completely automated the search of multiple purged issues at the click of a button.

> 600 Secs (if multiple purged issues are present)

< 60 Secs 90%

Smart Pad – The SMART Pad is a one stop shop for all the calculators, decision trees, share points, important URLs, tutorials, excel Macros, which are required by the processor to process a claim

120 to 140 Secs <50 Secs 58.33%

Omega – One click auto omega feed 30 Secs < 10 Secs 66.67%

ORS SSP– The Robot enables the user to route an ORS to SSP after auto scrubbing all the required information. The Robot auto documents the ORS and auto routes the claim to the appropriate SSP routing address.

120 to 140 Secs <50 Secs 58.33%


Embedded Robotics 4.2.1

29


Solution / Improvement Implementation 4.2.1


A single user interface which integrates all

required applications and SOPs and automates the research & determination

process.

Minimum Human intervention and determination.

Pre fed denial logic

Reduced Rework through Integration of Provider

Service and Claims research steps.

Reduced NAN defects

Reduced handling time


Enhance – Giant Leap 4.2.1

30


Algorithm

Automation

Simplicity

Accurate

Emulator

Embedded

Commentary

WAND

PEGA

EDSS

IDRS

Codes

Medical Policies

A SINGLE USER INTERFACE WHICH INTEGRATES ALL

REQUIRED APPLICATIONS WITH AN AUTOMATED

RESEARCH PROCESS

MINIMUM HUMAN INTERVENTION AND DETERMINATION

APPLICATION WITH PRE FED DENIAL LOGIC

REDUCED REWORK THROUGH INTEGRATION OF PROVIDER SERVICE

AND CLAIMS RESEARCH STEPS

REDUCED DEFECTS

REDUCED HANDLING TIME


Enhance – Giant Leap 4.2.1


X's Description Pre (Errors / Month) Post (Errors / Month) Assistance surgeon incorrect 6.4 0

Adjustment Not Completed 17.4 0

Suspect Duplicate Denied Incorrectly 12.4 0

Out-of-network paid in-network 7.2 0

Co-surgeon Incorrect 14.6 0

Co-insurance Error 12.4 0.5

Orate/Outpatient contract calculated incorrectly 12.2 0

Anesthesia Incorrect 9.4 0

History Research Error 14.6 0

Incorrect FN Denial 14.6 0

Duplicate Charges Paid 14.4 0

Authorization/Notification selection incorrect 14.8 0

Schedule Amount Error 18.2 0

Corrected Claim/Late Charges mishandled 14.4 0.5

OOP Calculation Incorrect 6 0

Negotiated amount incorrectly applied 15 0

14 DENIAL Related 10.5 2

Add on Policy Related 11 0

Allowable Conflict Related 16 0

Global Day Policy 12 3

Notification Related 16 2

Timely Filing Related 14.5 1

Project Results

Improvement in X Observed 4.3.1

31

© 2016 WIPRO LTD | WWW.WIPRO.COM | CONFIDENTIAL 61

2 Proportion test was used to validate process improvement

P value is less than 0.05, hence we can

conclude that there is a significant improvement

in Defect Rate Performance

Error Proportion Defective Sigma Multiple DPMO

Pre 0.00725 3.94 7255

Post 0.00059 4.74 589

90+ %

Reduction

in DPMO

Project Results

Improvement in Project Y Observed - PCRS 4.3.1


2 Sample T test was used to validate process improvement

P value is less than 0.05, hence we can

conclude that there is a significant improvement

in NAN %

Stage NAN % Sigma Multiple

Pre 19.13% 0.54

Post 14.74% 3.24

Project Results

Improvement in Project Y Observed - PPR 4.3.1

PostPre

0.22

0.20

0.18

0.16

0.14

0.12

Stage

NA

N %

Boxplot of NAN %

32


Accuracy Improvement

90+% Error

Reduction BPQM Audits

0 PG / TTP

Misses

OAR Improved

From 99.27% to

99.94% Zero Mispaid

100% DAR

Hygiene Improvement

Reduction in

SSP

Routes Defect

Proportion

3.27%

to 1.99%

Reduction in

MCR Routes

Defect

Proportion

9.15%

to 6.76%

Efficiency Improvement

Navigation

Time

Reduction

Robotics

Enabled Research

9.14% Improvement in Efficiency

Time to Proficiency

100% CPA, DAR

& PAR

Achieved

15.5% Efficiency

Improvement

Batch used GUI since Day 1 of Ramp Bad Rework (NAN) Reduction

NAN %

Reduced from 19.13% to 14.74%

DAR Benefit

$275K

Efficiency

Benefit

$556K

Volume

Reduction

$132K

Time to

Proficiency

Benefit

$55K

Annualized Benefit

Batch Operating at Zero Errors for

26 Weeks

Total

Benefit

$1.02 Mn

Replication

Benefit

$ 5.6 Mn Wipro Benefit:

Realized: INR 8.43 Mn

Annualized: INR 25.3 Mn

Project Results - Benefits Realized 4.3.2


Customer Commendations

Excellent results – if these are holding true we

need to get this implemented onshore as quickly

as possible.

- Blair Bass

WOW! 90.5% error reduction!!

- Brett Morgan

Great Robotics!!!

- Brian Smith

Amazing Tool!!!

Click of a button research is so

easy

- Faye Payne

Excited, awaiting onshore

deployment

- Kim Rudd

33


Section 5.0.0 Preservation and Stakeholder Communication


Sustaining Results Over Time 5.1.1

Sr No Key Solutions Continuity Approach Status

1 Deployment of Rework GUI +

Enhance Giant Leap

1. Tool merged with the Emulators for on claim

usage

2. Automated check on every claim

3. Embedded Robotics ensuring zero Manual

Intervention

Validated

2 Deployment of Barcode and

Re-Router Droid

1. Standard Corporate Letter formats changed

2. Any claim without the standard format would

be handled by the Re-Router Droid (Mistake

Proofed)

Validated

3 Business Partner Route

Tracking

1. Automated Macro deployed for tracking all

business partner routes before start of next

shift

2. Defaulter list auto attached to email – Mistake

proofed

Validated

4 Ongoing Vitality / Refresher

Sessions

Included in the Standardization Checklist as a

standard practice, which is audited by BB every

month

Validated

Evidence to Operating Strategy:

1) All solutions mistake proofed and automated into the system leaving no option to make an error / deviation

2) Solutions included as additional check points in the Account Standardization Checklist for monthly

compliance reporting

3) Validation – Sustained scores for 15 weeks + Standardization Score @ 87% (Project related checks

being @ 100%)

34


Sustaining Results Over Time 5.1.2

Benefits Sustenance

1. All solutions mistake proofed to avoid

manual errors or non compliance

2. Scores for Accuracy and NAN

sustained across Wipro and client

locations

1. Monthly review of the performance

metrics by Account heads

87.30% 87.80% 88%89%

100% 100% 100% 100%

96%

100% 100% 100%

Jul-13 Aug-13 Sep-13 Oct-13

Standardization Trending

Standardization Score Project Checks-Wipro Project Checks-Client

Evidence to Operating Strategy:

1) Monthly Standardization audits deployed at

Wipro and Client Org

2) Neutral party evaluations published

3) Validation

• Sustained scores for 15 weeks across

Wipro and Client locations

• Project related standardization checks

trending at 100% across Wipro and

client Org


Communication of Results 5.2.1

• Share all improvement project status with leadership team and all stakeholders

• Share project benefits and results with leadership team including Team involvement, Output, Revenue realized, client sat and sustenance results

Monthly QIC meetings (Quality Improvement Council)

• Share improvement projects with steering committee, Operations team and all Stakeholders

• Share project benefits and results with steering committee and stakeholders

Quality Circle meetings

• Prior to open houses, projects in the account are shared with benefits

• High impact projects are recognized

• Weekly Best Practice Sharing calls, wherein 1 Black Belt shares the learning from the project

• Pragati Badges as R&R for those who made a difference

Townhalls and Open House

• Wipro Newsletter, also including projects distributed in hard copies to all employees by HR

• CEO newsletter published every month highlighting results from all quality initiatives during the last month

• Project storyboard and account level summary uploaded on intranet for common sharing

Wipro Newsletter

35


Communication of Results 5.2.1

Pre Project Closure VOW (Voice of Wipro) Survey Conducted for

all projects

All stakeholders respond on a scale of 1-9, 1-3 being Dissatisfied, 4-6 being Neutral and 7-9 being

Satisfied

96% of the stakeholders responded for the Rework and Re-Rework Reduction project

Grading Criteria:

1. Your Involvement

2. Output Satisfaction

3. Business Benefits

4. Client Satisfaction

5. Sustenance

6. Overall Satisfaction with project

Results:

1. 96% of the stakeholders responded

2. Satisfaction quotient (average of all ratings) was 8.48

3. All responses were satisfied response

4. Rating of 7 received from Business Finance Team,

due to additional cost of development resources,

which has a recovery timeline of 2 months

Sr

No

Stakeholders Avg. Satisfaction

with the Project

1 Business

Finance

7.2

2 Business

Head

8.7

3 Operations

Head

8.6

4 Client Ops 8.2

5 Client

Business

9

6 MBB 9

7 Champion 8

Average Score 8.48


The Journey Continues…

Claims Customer Service

Rework and Re-rework Reduction - ASQ€¦ · Rework and Re-Rework Reduction ... Subject Matter...

Documents

Transcript of Rework and Re-rework Reduction - ASQ€¦ · Rework and Re-Rework Reduction ... Subject Matter...