System processes N.Y. claims in a hurry

By Claire E. HouseGCN StaffA document management system is helping New York process workers' compensation claims faster than ever.The state Workers' Compensation Board has replaced overflowing cabinets and easily misplaced paper files with databases and .tif images of the 1 million pages of claims documents it receives monthly.The board's paper system was an inefficient time-eater. The board took 30 days or longer to open a proceeding from the time the initial case documents arrived.'We're dealing with injured workers, people who rely upon our efficiencies to maintain their lifestyles or even sometimes make the next mortgage payment,' public information director Jon A. Sullivan said.Now board staff members assemble cases within a week, through the Electronic Case Folder application. The document management system has let the board improve business processes and open a series of service centers around the state.System implementation began in May 1998 and will cost $50 million'$13 million of which paid for converting existing files. The board remained open for business as it digitized 38 million pieces of paper from 350,000 open case files, chairman Robert R. Snashall said.The board sets up case folders for employees who suffer work injuries resulting in lost work time, permanent disability or death, executive director Richard Bell said. It also adjudicates disputes between insurance companies and claimants.As a result, claim-related documents from medical providers and insurance companies continually pour in. Insurance companies report injuries, wages and lost time, and doctors provide medical evidence.The documents arrive at board headquarters in Albany or at one of nine district offices throughout the state. Vendor QCSinet Corp. of Miami, owned by FYI Inc. of Dallas, picks up the documents daily and drives them to its Binghamton, N.Y., facility.The company preps, scans and indexes document images. Its employees use 18 high-speed Document Scanner 5500s and 7500s from Eastman Kodak Co., QCSinet vice president Bill Travis said. VersaScan software from Quatex Inc. of Fairfax, Va., digitizes and manages the document images. A proprietary program performs data capture and quality assurance.QCSinet then ftps the images and data to the Claims Information System (CIS) at the board's Albany computer center.'We literally import 50,000 to 60,000 images a night,' said Barrett Russell, deputy executive director of systems modernization.CIS, developed by board systems staff in Sybase Inc. subsidiary Powersoft Corp.'s PowerBuilder, deposits the indexing data into a Sybase System 11 database running under AIX on an IBM RS/6000 server.Images move separately through Integrated Document Management Information System 3.4.1 software from FileNet Corp. of Costa Mesa, Calif. FileNet's High Production Image Import process shoots two copies of each image file into the system: one to a master optical jukebox in Albany, the other to a jukebox in the district office where the case originated.'We enhance the response time by storing [the image files] locally,' Russell said.The Albany computer center and a New York City district office each store images in a FileNet OSAR-107 GTL optical jukebox. The other eight district offices use IBM 3995 series Optical Library Dataservers.Based on indexing data such as case number and jurisdiction number, CIS determines which examiner in which district is managing a particular case.The system refreshes each examiner's work queue so the new data appears automatically at log-in.Meanwhile, the FileNet software checks the work queue and 'prefetches' pertinent documents by storing them in cache for quick retrieval by the user.The user can then open the Electronic Case Folder app, click on a file's table of contents and pull up a document image. The system links data and images through common document identification numbers.Users view the data and images side by side on standard 21-inch monitors.'It's enabled us to change the profile of the board's work force so that we no longer have to have hundreds and hundreds of people whose job it is simply to move paper around the agency,' Russell said.The change didn't come overnight. Board staff members and consultants have spent more than 37,000 hours training system users, many of whom had never used a computer before, he said.That training has paid off by speeding claims processing. Under the former business method, the board's administrative judges held hearings for most cases.Examiners now have the tools and training to informally review cases themselves. Judges still sign off on every case but hold hearings only for the most difficult ones.Judges previously roamed the state and held hearings in temporary digs such as fire halls, community centers, 'all sorts of odd places,' Bell said.Now the board has 30 full-time customer service centers around the state not only to hold hearings but also to provide immediate file content access to claimants, attorneys and insurance company representatives. Internet access is in the works, Russell said.The centers connect to the district offices, which connect to headquarters'all via T1 lines.The average case file has 72 pages of information, and the board typically has 300,000 open case files at any one time.Board officials plan to reduce the number of open cases by using the system to close cases faster than they open them.Sometimes the board must reopen a closed case if additional issues pop up.'That used to be a nightmare under the old system,' Bell said, because files were often incomplete, impossible to find or sent to off-site storage.'The files are now 'at our fingertips,' Bell said.