Your claims department is excited about the benefits of the new claims administration system you are planning to install. The demos went well, and now the hard work of planning your implementation and data conversion approach is about to begin. There are many decisions which must be made which affect the magnitude and complexity of the claims data conversion.
Do you convert only open claims, recently closed claims or all closed claims? How fast do you roll out the system? If you pilot new claims processing first, how long do you wait before you convert historical claims? Do you maintain the old system for inquiry purposes or retire it? How will you insure the accuracy of your statistical reporting if you convert open claims? How will you secure access to make sure no activity is performed on converted claims in the legacy system?
While project needs will vary by carrier and line of business, here are some things you should consider when planning the data conversion portion of your implementation:
- Enable Cross Reference: If the new system requires a new claims number, then a claims cross reference number file must be maintained, and inquiry capabilities must be made available to your service teams and incorporated into your websites and self-service applications.
- Don’t Delay Conversion of Open Claims: Delaying conversion of open claims allows short-tail claims to run off and reduces the claims conversion times as well as claims data conversion issues. However, this delays benefits realization and keeps the claims organization in two systems longer and complicates management and financial reporting. Generally speaking, once the functionality is verified, faster is better.
- Don’t Convert What You Don’t Need To: Challenge the amount of data to be converted. Understand how often claims are reopened by line of business and how far back you need to go to facilitate normal operations. Converting extremely old information adds complexity. This can sometimes be avoided if imaging systems or other methods for inquiry exist. Also, make sure you understand what transaction history is available in data warehouses or other reporting systems.
- Resolve Data Quality Issues Early On: Running historical claims data through the new edits of the system can be time consuming. Make sure you sample data quality well in advance of planning conversions and resolve data quality issues. Quite often, allowances need to be made for obsolete values in tables in the new system. Make sure these are marked as conversion only and are not displayed in drop down menus for selection. Benchmark runtimes and plan on needing to spend time tuning the conversion efforts.
- Develop Error Handling Routines: Expect recently entered data to create challenges just prior to conversion. This can happen no matter how locked-down your processes may be. Conversion programs need error handling routines that record and bypass problems. Run your data quality reports frequently prior to conversion.
- Rigorously Test Transactions Using Converted Data: Lastly, plan on extensive testing of transactions on converted data. Many new systems have triggers that must be set properly which are often overlooked on conversion mappings. The first time your run a closed claims report for the current month, you may find that you get every converted claim unless the proper flags have been set based on the new system requirements.