Your claims administration software contract has been finalized and signed. Now what? How do you go from looking at claims administration software vendors for the past six months to actually using claims administration software in your day-to-day operations? The answer? Implementation. Implementation is the magic that turns the concept into reality. But what does it take to knock your claims software implementation out of the park? Let’s take a deeper look.

What is Implementation?   

Implementation is the systematic approach to effectively integrate your claims administration software into the workflow of your organization. This step is critical to ensure the software you selected will deliver on its promises.

During your claims software implementation your vendor will assign a projects team that will go through a deep dive into your goals, objectives, and processes to develop a comprehensive project plan. The project plan will: develop the scope statement; identify deliverables, create the work breakdown structure, identify activities needed to complete each deliverable, estimate the resource requirements (time and cost for the activities), develop the schedule, plan for risk, and gain formal approval to begin work.

Here are specific steps to follow during implementation:

1. Review the project schedule. Your vendor will put together a project schedule with milestones and target dates. Review the project schedule and:

  • Identify your questions– What is not clear on the schedule? What people do you need involved in each phase?  Are there items not accounted for in the schedule?  Do the items being implemented make sense in your business workflows?  Do you need critical business workflows to happen before others?  Are all the products you purchased listed on the schedule?
  • Look at the milestones and dates – How do those dates correspond to your business schedule? Can other departments work with those milestones and dates? Is senior leadership committed to these milestone and dates?   If there are other vendors involved, can they follow those milestones and dates?  Keep in mind that milestones and dates are flexible at this point, but can be easily missed because of miscommunication.

2. Prepare for implementation. After the living and breathing project schedule is in place, the real work begins. Multiple components are typically implemented concurrently with claims administration software, and the following checklist can help you keep everything on track:

  • Identify your team members. Who is going to collaborate with the software professionals during the claims software implementation? Do your team members have the business acumen, required time, resources, understanding of the organization’s business needs, and a commitment to a successful claims software implementation?  Are your team members going to be champions or coaches of the software through implementation and beyond?  Are your team members empowered during the project? Do you have someone who can serve as an internal project manager? (We highly recommend doing this.)
  • Identify in great detail current workflows. Often organizations want to change or improve their workflow when implementing claims administration software. As you map out your workflow, identify any redundancies, gaps, and existing in-efficiencies. Ask your software vendor to review and provide recommendations to improve processes. While the vendor can share ideas about configuration, ultimately those ideas need to be vetted within your organization to determine if your business requirements have been addressed.
  • Level set expectations. Implementing new software is a huge commitment and change for any organization – and not every person will be jumping for joy. Be prepared to manage the difficulties, regression, negativity, and change in vision.  Do you have a proactive plan to manage the expectations through ongoing software support?
  • Collaboration and communication. Solid two-way, collaborative communication within your organization and with the software vendor is critical. Do both parties have plans in place to ensure that collaboration and communication will continue throughout the life of the relationship?
  • Training and Adoption. What are your plans for training your employees to use the new software?  What mechanisms have you set up in your culture to embrace or adopt the software?

3. Begin the implementation. Implementation is often conducted through a series of conference calls, webinars, and exchanges of data and documents. At times, onsite visits may be necessary to work on specific milestones.  At each milestone, conduct a review to evaluate if everyone is aligned, and work is progressing as anticipated. Throughout the claims software implementation process, many discussions and decisions are made around workflow either in the software or the business.  It is important all of this is documented in case it results in scope changes in the project or to your own business needs.

4. Test the Claims Administration Software. Testing the claims administration software is critical to ensure the success of the project. Testing often occurs at many different stages, from testing a single workflow, to testing a single workflow in a full process, to finally testing the end-to-end process. Many customers want to rush through this process because they have felt the workflows have been talked about ad nauseam. Unfortunately, rushing through testing can result in a lot of rework in the post go-live environment. It is important to have your employee(s) responsible for the workflow test the process by focusing on the following:

  • If the workflow is the same as your process today, is it the same in the software? Mirror your daily activities in the new software to ensure you are not missing a step in your workflow.
  • If changes were made in your business workflow, are those changes accounted for and working in the software?
  • Identify gaps or enhancements in your workflow. Do you have a solution to fill the gaps?  Showcase those enhancements in your training at go-live.
  • Communicate any items not working in the test or any gaps to your software vendor.
  • Retest often.

5. Software go-live. You are on the home stretch. Countless hours have been logged to develop your business workflows in the new software application. Your testing has been thorough, and the software application is working to the level you need to go live.  Now what?

Remember when you chose your team members for their ability to be a champion or coach at the time of going live?  Now is the time to rely on those team members to help you determine the best way to train your employees on how to use the new software. Your software vendor will provide training for you, but you define the way your users will be trained, what they will be trained on, how they will be measured during the training, and how well they are able to adopt what they learned.  Work collaboratively with your software vendor to write a training program that will ensure a successful implementation of your software.

6. Train users and promote adoption of the claims administration software within your organization. Each champion and coach will be key training users and helping the organization adapt to the changes. By demonstrating the enhancements made to your workflow, you will encourage users to appreciate the benefits the software can provide to their everyday activities.

The implementation of your claims administration software is a large undertaking and should not be taken lightly.  Properly preparing and reviewing the project schedule is critical to the early success of the implementation. Testing the software will not only capture any gaps in workflow or functionality, but it also will identify potential opportunities for further improvement. With the proper preparation you can feel confident that workflows are complete upon go-live, and you can focus your efforts on training your users and maximizing the value of your software investment. And that’s bound to be a home run for your organization.