Tuesday, March 28, 2017
Industry Models Insurance

The Insurance Industry is about understanding risk and managing investments. But the more a company spreads its investments across the globe, the more difficult risk management becomes. One of the greatest risk management tools available to insurance organizations is effective master data management. Industry studies show that those companies which focus on data management can leverage that investment for a significant competitive advantage. The unique benefits of Microsoft Master Data Services combined with Profisee Master Data Maestro provide the flexibility and power to provide just the edge your enterprise needs.

Maestro Insurance provides best-in-class master data modeling and data quality controls, and an accelerated deployment path for rapid time to value, while minimizing cost, resources, and risk. Maestro Insurance components are modular in design, allowing payers and providers to implement only those components that directly meet their business needs and requirements.

End-to-end Insurance MDM

Maestro Insurance, constructed from Profisee’s extensive real-world experience and collaboration with professional insurance associations, delivers a comprehensive insurance MDM solution—expansive data model and ACORD compatible reference data; matching, survivorship, and data quality strategies; integration, collaboration, and governance services; expert skills transfer and implementation services; and complete platform and solution support.

Fixed-Price

Maestro Insurance delivers all the software, master data models, and skills you need to be successful in a single investment. From day one, budget, investment, and ROI are known–no hidden costs exposed later in the project, no transaction fees for data quality, no variable record volume costs based on the size of your business or data models, and no extra fees for tackling your next data domain.

Self-Sufficiency

Maestro Insurance encompasses education and skills transfer as critical components of solution delivery. All Industry Solutions include full classroom training, extended project documentation, and skills transfer. Short term self-sufficiency is key to leveraging your team, executing on optimal ROI, and efficiently delivering additional MDM and reference data solutions in the future.

MDM Expertise

Profisee is a full-service MDM provider, delivering best-in-class software, comprehensive industry models, and expert services and support. For resource constrained customers, Profisee provides complete turnkey services—from basic SQL Server installation, to insurance-specific model extension, to establishing best-practice business processes and data governance programs.

Benefits of Master Data Maestro for Insurance

Full-featured Insurance Model

Leveraging all of the capabilities of Master Data Services and Maestro, the insurance model contains nearly 200 entities, such as party(Person and Organization), Producer, and Policy, as well as 1000 attributes, such as NAIC Codes, SIC codes, and Rider (Types, SubTypes, Categories). Relationship hierarchies, attribute groupings, security roles, and personalized workspaces provide optimal efficiency and productivity for data stewards from the start. Compatible with many industry standards, Maestro Industry Solutions provides users with a consistent model to accelerate implementation while providing the ability to customize to match their unique business requirements.

Data Quality

Business Rules – Maestro Insurance ships with over 100 pre-configured business rules to provide instant feedback on data compliance with industry standards. Maestro and MDS provide users with the easy-to-use interfaces for managing and extending these rules.

Location & Contact Data Services – Maestro Insurance embraces the very best in location and contact data quality services built directly into your MDM platform—all at a fixed price and without any per-record transaction fees. Address standardization, location verification, and contact and email verification strategies improve data accuracy and provide necessary standardization for high-quality person and location matching results.

Matching and Survivorship Strategies – Maestro Insurance delivers pre-loaded matching strategies for central entities such as Patient and Provider. Survivorship strategies are configured to master the best data to form the optimum golden record, as well as harmonize golden record data back to source records. Synonym lists improve matching accuracy by standardizing common nomenclature discrepancies.

Integration Service Accelerators

All major entities contain a corresponding Integration Services package to assist users in building integration both within and outside of the MDS model. Large entities include entity specific reference data integration packages to load ACORD compatible reference data.

Reference Data Support

Leveraging economies of scale for Maestro Insurance customers, Profisee provides an ever growing list of insurance-specific reference data. Maestro Insurance supplies customizable mappings and packages to support reference data integration within every subscribing organization.

Customizable Storage

While the Insurance industry model initially provides all standard ACORD Master entities, such as patient, physician, and locations out of the box, Maestro and MDS allow for customization of these entities to include additional file attributes to store images or links to external MRI data.

Hierarchy Management

Maestro and MDS can support any number of hierarchies on any entity. The Maestro Insurance industry solution includes over 20 of the most common hierarchy structures around common reference data entities out of the box. These hierarchies only require you to load your data into the standard reference entities to become fully operational.

Versioning

MDS versioning and additional Maestro features can be leveraged to manage versions of data across different months, thus providing the capabilities to manage acquisition models pre and post-acquisition, and you can even synchronize across multiple versions using Maestro reporting.

Managing All Types of Insurance

Maestro Insurance provides entities for all types of insurance companies leveraging ACORD based structures for all insurance products. Reference and look up data is provided for each of the four sub-Industries of Insurance:

  • Life & Annuity
  • Health
  • Property and Casualty
  • Re-Insurance

Maestro Insurance Common Use Cases

A “Single View” of Client

Merge physical records from multiple sources, match records with Maestro Golden Record Management, and automatically master golden records with automated survivorship strategies to deliver the best view of clients and organizations.

A “Single View” of Policy

(Medicaid or other policy information) Merge state-based systems, create golden records for persons moving across states, losing coverage, and/or re-gaining eligibility.

Easy Data Steward Actions

  • Cleanse patient and physician records to reduce processing and duplicate care costs.
  • Use derived hierarchies to quickly navigate Rider features across policy products in an effort to judge risk or potential marketing opportunities.
  • Improve data stewardship of patient information flowing through existing Electronic Health Record (EHR) and Health Information Exchange (HIE) applications.
  • Determine hotspots for risk by analyzing organization overlap across products.

The Short and Sweet

Maestro Insurance provides the starting point for insurance companies seeking to leverage world-class master data management software developed around the Microsoft SQL Server platform. Maestro Insurance encompasses the master data platform and integrated data quality services necessary to tackle complex requirements, while at the same time helping your organization leverage specific ACORD data models around common master data and reference data standardizing processes across your organization.

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