Sharpen Your Claims Process

Process mapping your claims

A claims department can have significantly varying flows depending on the type of losses that are being handled within a specific group. Property departments may handle things differently than liability departments do. An auto handling office will have a much different procedure as compared to the workers’ compensation department. A manager’s role is to manage these processes and ensure that they are efficient. One technique for making sure that these processes run smoothly is called process mapping. Process mapping your claims procedures can identify inefficiencies to make sure your office runs smoothly.

A process map can also be called a flow chart, process chart, functional flow chart, or workflow diagram. It is basically a visual representation of the steps in a process. 

Why Create a Process Map?

The advantages of working through a process map are that an organization can improve its efficiency by identifying bottlenecks, repetition, or delays in the process that could be solved when people work together.

Creating a process is similar to making a recipe. There is an initial statement of what you want to cook, there is the gathering of all the ingredients, and there are step-by-step procedures for assembling all the ingredients and preparing to combine them into a final meal. Process mapping is really no different.

Process mapping is a visual rendition of the process. These visual renditions not only help define the process for users but also provide a structure from which a claims manual can be built. Process maps can be refined and changed as needed whenever something within your department changes, such as a new procedure, new personnel, or new regulatory requirements.

How You Can Start Process Mapping Your Claims

Many techniques can be used to prepare a process map. Software systems are available, such as those that are designed to graphically show what the process does. However, if you are in a group setting, which is the best way to develop a process, the sticky note method works best. The sticky note process involves using multi-colored three-inch sticky notes and a large wall that everyone in the room can see. This is an exercise in team-building as well. Depending on the number of individuals in the room, the session can be performed in various ways. However, as an example, we will consider a claims department with five people who have five different functions within that department. 

To start, each individual can be given a package of sticky notes and asked to write down 10 specific things that they do throughout the day. If 10 things are too many, limit it to five. Once these are gathered from the participants, the sticky notes can be placed on the wall so that everyone can see them. Then the work begins. You will need to determine in which order those specific tasks go. It can start to get confusing, especially when tasks are handled at one stage by one person and at another stage by another person. 

This is where the technique of swim lanes can come into play. It is best to use a whiteboard for this process if possible. If not, simple light blue painter’s tape can be used to designate lanes on the wall. Each lane will represent an individual or a department. The sticky notes can be placed within those lanes and can move from one lane to another, if necessary. 

As the process is mapped out, it’s best if arrows can be drawn between the sticky notes to show the flow of the work.

Traditionally, different symbol shapes are used for different activities. For example, the start and finish of a process are usually designated by a circle or an oval. When using sticky notes, try to use a different color for the start and finish. After that, each step in the process is usually designated by a square or a rectangle. Whenever a decision must be made, it is best to turn the sticky note so that it becomes a diamond. With these simple shapes in mind, it is very easy to structure a process and graphically show how that process is carried out from start to finish.

Manage For Success

Process mapping your claims can become very complex as decisions are made throughout. However, the advantage of laying out the process graphically is that it is very easy to see when decision diamonds create inefficiency loops. An inefficiency loop is when a decision results in an answer that takes the process back to a starting point. Showing these inefficiency loops graphically can help everyone understand where the bottleneck occurs and how to correct it.

Some organizations will participate in process-mapping projects that take several months to perfect. Once the process map is in place, it can be maintained with just minor tweaks over time.

From a practical standpoint, having all the sticky notes on the wall with drawings and notes can be burdensome if everything is kept in one room. A simple snap with a cell phone camera and a transfer to an email can distribute that information as a document to all the participants and to management so that everyone understands what the process results were. If you find bottlenecks or inefficiencies in your claims department, consider setting your staff up for a process-mapping session. They work quite well, are easy to accomplish, and can be great team-building exercises.

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