IT Firm Helps Health Insurers Adapt to Reform, Reduce Costs with Integrated Solution

In response to healthcare reform initiatives in Germany, IT services provider spectrum|K developed a scalable solution to automate the complex “additional contribution” process. Using Microsoft Dynamics CRM 4.0 Enterprise business software, Microsoft BizTalk Server 2009 Enterprise, and Microsoft SQL Server 2008 Enterprise data management software, spectrum|K expects to help public insurers reduce administrative costs and improve efficiency.

Business Needs
Based in Berlin, Germany, spectrum|K is a technology services provider specializing in information, contract, and healthcare management. The company supports health insurance providers by creating solutions that address complex technical, legal, and commercial requirements.

In response to changes in the German healthcare system, spectrum|K saw an opportunity to develop a new solution for health insurance providers. As part of a comprehensive healthcare reform initiative, the German government introduced the Zusatzbeitrag—or “Additional Contribution”—initiative: to help offset the rising cost of health insurance, individuals can make additional contributions to health insurance providers. This initiative requires health insurers to directly request, process, and manage payments from their 51 million members. “Tracking the supplemental contributions dramatically increased the number of accounts that these organizations needed to manage,” explains Yves Rawiel, Department Head of Customer Management at spectrum|K. “However, the insurers lacked a revenue management or automated collection processing solution.”

To fully automate revenue collection, insurance companies needed to combine diverse data sources, business-critical applications, and nearly 85 sub-processes into an integrated system. These applications and processes included ISKV insurance software, applications that are used by external service providers to verify addresses and household incomes, systems designed to send requests for payment and scan direct debit authorizations, and financial solutions that are linked to payment types, such as electronic payments, direct debit, and credit card transactions.

“Insurers needed to be technologically ready for this reform initiative, or risk losing most of the revenue to increased management expenses,” explains Ingo Werner, Managing Director of spectrum|K. “Because the supplemental contribution flows directly into the insurance pool, we wanted to help these organizations implement a cost-effective solution to track every cent.”

Solution
In preparation for the healthcare reform initiative, spectrum|K—along with Microsoft Gold Certified Partner disserto management gmbh—launched the Additional Contribution Project in the summer of 2008. The two companies developed a solution that merges the numerous data sources, partners, and processes into a unified system through a dedicated information hub.

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*The beauty of Microsoft technology is that all the products work together seamlessly. By combining different products, we built a complete system that we couldn’t have found anywhere else.*

Ingo Werner
Managing Director, spectrum|K

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The central element of the solution is Microsoft Dynamics CRM 4.0 Enterprise business software. The company relies on Microsoft Dynamics CRM to help customers analyze data and manage relationships with external partners. spectrum|K can configure the information hub to automatically log tasks in Microsoft Dynamics CRM, and to capture discrepancies between source data and validated member data. Also, spectrum|K customers can quickly retrieve additional contribution status and verify member data.

The solution also includes Microsoft BizTalk Server 2009 Enterprise (to synchronize the various data formats) and Microsoft SQL Server 2008 Enterprise data management software (to process and manage the significant volumes of data generated by the additional contribution process).

Sensitive social data was managed in a protected area of the BITMARCK data center in Essen, and—to meet stringent governmental regulations—needed to be painstakingly separated from all other systems. “The German Federal Insurance Office requirements are very specific,” explains Rawiel. “By using mandates and access permissions, we managed to fill all of them. After all, each insurer should only be able to access its own member data.”

In September 2009, spectrum|K finished creating the solution and made it available to insurance companies in Germany. In the future, spectrum|K plans to use Microsoft Office Professional 2007 to create standardized documents by extracting addresses and boilerplate text from Microsoft Dynamics CRM and importing that information directly into Microsoft Office Word 2007 using Office Business Applications.

Benefits
In February 2010, the first of several insurance companies began to use the spectrum|K solution to process additional contributions from their members. Health insurers appreciate that the solution is easy to use, flexible, and will help cut costs by streamlining management.

Ease of use. By using the spectrum|K solution to track additional contributions, health insurers now can manage a very complex process easily. They can use the dedicated information hub to pull member data from the ISKV software, verify it, check for liquidity, and post the direct debit request to the bank. This process takes less than 24 hours.

Increased flexibility. Health insurers can easily track the progress of each contribution using Microsoft Dynamics CRM. Verified address data is provided at the end of the process to be re-imported into the insurer’s ISKV system. “We really like the flexibility of the process,” Rawiel says. “We can offer several different versions of additional contribution management as a product. That’s important to our business because health insurers all use a different structure.”

Efficient process management and reduced costs. In addition to using Microsoft Dynamics CRM on behalf of health insurers to manage customer and vendor relationships, spectrum|K plans to use the customer relationship management solution in conjunction with Microsoft Office 2007 to optimize its own customer management. Employees will be able to access clients, templates, and standardized text directly from Office Word 2007. “This will provide us with legally correct and unified documents and save an enormous amount of time,” says Rawiel. By mid-2010, all 100 workstations at spectrum|K should be equipped with Microsoft Dynamics CRM 4.0.

“The beauty of Microsoft technology is that all the products work together seamlessly,” Werner concludes. “By combining different products, we built a complete system that we couldn’t have found anywhere else.”

For more information about other Microsoft customer successes, please visit:
www.microsoft.com/casestudies

Customer Size: Large Organization
Industry: Health
Country or Region: Germany
Solutions:
  • Microsoft Dynamics CRM 4.0
  • Microsoft Office Professional 2007
  • Microsoft Biztalk Server 2009 Enterprise
  • Microsoft SQL Server 2008 Enterprise
Organization Profile:

Technology services provider spectrum|K specializes in IT support for health insurance providers. The company’s 100 employees are based in Berlin, Germany.

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