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Maryland Internet Claims System. Carol Walter Systems Development May 24, 2000. History of the Project. ITSC Began Interface 1997 Initial(reopen,additional) Claims Only Prototype Field Tested 1998 Screen scraped to Mainframe Deferred by Reengineering & Y2K. Meanwhile.

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Presentation Transcript
slide1

MarylandInternet Claims System

Carol WalterSystems DevelopmentMay 24, 2000

history of the project
History of the Project
  • ITSC Began Interface 1997
  • Initial(reopen,additional) Claims Only
  • Prototype Field Tested 1998
  • Screen scraped to Mainframe
  • Deferred by Reengineering & Y2K
meanwhile
Meanwhile ...
  • Shift to Claims by Phone
  • Job Service Moves to Self Service Using Intranet
  • One Stops Want to Take Claims

Challenge: New Service Network

slide4

Take the Claim:

By Phone

By Internet

Follow Up:More Information

Targeted

Call In:

LocalPriorities

Reemployment Services

internet claims 2000
Internet Claims 2000
  • Internet Claims Taking Must Be Fully Self Service
  • Expand Public Access
  • Fully Automate Internet to Mainframe Interface
  • Reduce Agency Costs
current information flow
Current Information Flow

Claimant

to Staff

Staff toComputer

internet claims information flow
Internet Claims Information Flow

Claimant

to Computer

Computer to Staff

use available data with care
Use Available Data - With Care
  • Protect Confidentiality
  • MVA cross check? Long term.
  • Short term: Don’t pre-fill claimant data.
don t collect redundant data
Don’t Collect Redundant Data

New Claim

Additional/Reopen

Contact Info

Personal Info

Dependents

Eligibility Info

Complete Employment

Intervening Employment

Contact Info

Eligibility Info

Intervening Employment

When SSN, Name, Birthdate Match

guide the claimant to good employment data
Guide the Claimant To Good Employment Data
  • Display wage record employment in search results
  • If not found, offer memo box for claimant description
  • Queue for staff call back
provide 24 x 7 access
Provide 24 x 7 Access
  • Internet Application will Need:
    • Current wage & employer records
    • Name, SSN, Birthdate, BYE
  • Transfer Claims As Soon As Possible
  • Mainframe Processing Must Handle Duplicates
fully automate the interface
Fully Automate the Interface
  • Edit all mainframe input
  • Determine Transaction Type
  • All issues are queued for staff
  • Staff can edit and resubmit on line
provide real time interface
Provide Real Time Interface
  • Staff have up to minute claims
  • Issues are identified immediately
  • Staff can follow up same day
never lose a claim
Never lose a claim
  • Internet claim provides confirmation number to claimant
  • Claimant told what to expect
  • Internet claims database tracks status
  • Mainframe sends receipt back to Internet claims
  • Mainframe processes or queues for staff
  • Comparative reports
proposed interface
Proposed Interface

First, identify the claimant and find existing records

MICS: Collect SSN, Name, Birthdate

MABS: Find claims

Find Employers

Store in MICS Database

SSN, Name, Birthdate

BYE, Employment

InitiateClaimsTaking

slide17

Second, take the claimthrough the internet

When connected, send to MABS

Is there a current

claim?

MICSDatabase

Collect Short Form

Collect Long Form

Completed Claim Data

slide18

Claim data

MABS:

Edit data

Find existing claims

Determine transaction type

MICS Database

Staffcorrect

claim

ClaimData

Receipt

Is claim ok?

Queue for Staff

No

Third,

process the claim

through the mainframe system.

Yes

MABSDatabase

Transaction Data

SubmitMABS

Transactions

the value added
The Value Added ...
  • Reduce Cost
    • Less Staff Time Per Claim
    • Clean Claims
  • Increase Access
    • Claims Taken Anywhere / Anytime
    • Part of Network of Self Service Offerings
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