As the economy has improved and competitive pressures highlight antiquated systems along with the dramatic need to support dynamic, online customer experiences global enterprises are looking for the “right” technologies and architectures. One might almost hear Bill Maher with one of his “New Rules” bits. But the rules here are not funny. Indeed make or break to both acquire and keep customers with either modernized legacy systems and or new platforms for doing business. Case study written by Paul Hessinger of InRule Technology.
This is a brief summary of how a global heath insurance company chose thinking in rulesTM and BRMS technology to do both. In a thought-full approach an innovative Proof of Concept for how CRM and BRMS along with other technologies such as Azure for cloud based delivery and operation of systems was undertaken. Microsoft Consulting Services and BRMS “ROAD” (Rule Oriented Architecture and Application Design/Development/Deployment) experts collaborated with the company’s IT team. Simply – put it proved the concept and provided a pro forma architecture for leveraging rules to get decisive results.
British United Provident Assurance (BUPA) Ltd is based in London. It establish a compelling if not visionary program called Vision 2020. It laid out a challenging transformation agenda. It faced the penultimate requirement that a rules based approach addresses – “just say no to hard coded logic.” BUPA had legacy systems in its Bupa Health Funding (BHF) business part of its UK Market unit based in Staines, outside London that used a number legacy technologies including an old BRMS. Changing rules in the claims adjudication and processing systems was difficult at best. Starting in early 2014, the system began a migration to a MSFT DYNAMICS CRM (with a dash of salesform.com as well!) based system for sourcing data.
A BRMS that puts the logic in the hands of those who know it best, is used now to validate claims (aka filter invoices), adjudicate claims (eligibility, pay limits) and a consumer focused cost estimating. Business personnel rewrote updated rules and the initial deployment was completed in 5 months processing 45000 claims per day. Rules allowed the ability to aggregate and pinpoint nuances in reimbursement amounts. There is an analytics benefit with more decisive decisions about how logic changes will affect future payouts to customers. By June of 2015 over 50% of the legacy rules had been modernized and migrated from the old rules to new rules with a rallying cry of both IT and the BRMS vendor “friends don’t let friends hard code logic.”
New Market Results:
Vision 2020 also called for entry into new markets. Under the direction of a senior global IT exec who also carried a title of Business Transformation Director a partnership with the largest bank in Hong Kong was established. Rule authors in London adjusted core rules for pricing, quoting and onboarding that allowed for an Azure, Dynamics CRM OnlIne and BRMS portal to cross sell health insurance in the banks retail branches when a customer wanted to open credit card account. The original POC was leveraged as the design starting point The system went live in less than 6 months and dramatically accelerated the time in which a new customer was set up with the bank’s credit card business and healthcare insurance from Bupa.
And then that system allowed Bupa’s first entry into a massive market – China. The bank partnership was extended. Rules were again quickly adapted to the Chinese market and the system is going live as these words are typed.
Bupa has established the BRMS as its global technology component when modernized or new systems will benefit from “new rules”/thinking in rules. Another project is underway in the Kingdom of Saudia Arabia and Bupa Australia built its own comprehensive POC that was done in 3 weeks (using better approach to rules majority of POC claims where within 10 cents of expected coverage and rules had queries embedded that were able to execute directly with SQL Server for faster performance) as it now begins a legacy modernization project with far reaching implications for its realization of Vision 2020
Proof that thinking in rules can rule as you consider legacy modernization or entering new markets with systems that have dynamics if not complex logic that is best handled by subject matter experts.
Thinking in rules is a register trade mark of InRule Technology, Inc.
Information About InRule: http://www.inrule.com/