Developing A BPMN Model For Insurance Claim Handling Process

Task and Gateway Requirements

1.

Save Time On Research and Writing
Hire a Pro to Write You a 100% Plagiarism-Free Paper.
Get My Paper

Figure 1: BPMN Model for Finance Bank Co Internal Procedure Manual Change Of Details Process

(Source: Created by Author)

The process starts when processing staff member will search for other similar requests has been done on the main queue. The staff load the form in image view. The missing filled are requested from the customers. The case is closed through sending PDA or updates are available. If all the required fields are not filled, then the customer is contacted. Otherwise, the filled data are validated. To validate the data supporting documents are needed. The staff check if those documents are present. If the documents are missing then again the customer is contacted and 2 weeks are waited to re-start the process. After data is validated, staff open CustomerBDcrm. If the customer is not present in the system then PDS is sent to the customer. If for changing data additional data is required then contact centre is instructed to collect those required data. The organization strongly focuses on storing all the data. Changing data does not mean old data must be deleted. Along with changing data, the old data is stored in audit log. If the change is related to pension payment then re-indexed to pension queue done. After all the data are properly validated and all data are present then data are stored.

Save Time On Research and Writing
Hire a Pro to Write You a 100% Plagiarism-Free Paper.
Get My Paper
  1. Check if critical fields are empty (Process: Check if all fields are filled)
  2. Check and fill all the data (Process: Contact customer and fill fields)
  3. Supported by appropriate documents (Process: Validate data)

3.

Figure 2: The Insurance Claim Process Model

(Source: Created by Author)

The process starts when a claim handler receives a claim. If the policy is not valid then request is cancelled. Otherwise, claim request data is entered into the system. The assessor service CTR evaluate the claim request. If the incident is not covered then request is cancelled. Otherwise, preliminary estimation of claim is done. If the primary estimate exceeds $3000 then on-site investigation is authorized by Assessor Headquarter. If the report says that incident was covered then price damage is calculated. Otherwise, the request is cancelled. The case is approved and forward to Senior Assessor. The senior assessor check claim case for both approved case and preliminary estimate under $3000. The senior assessor approved the claim forward the request to Document Control Department. The payment is sent to client. The case is finally closed and file is claimed by the document control office. The claim handling is completely managed by internal staff. For investigation, organization can hire third party but that is seen in very rare cases.

Sources for Developing the Process Model

3.The process mining aims for discovering the significant information through an event log very easily. The collected information through process mining can be later utilized to implement an organization wide system or analytical method that assists in auditing. The existing business process will then improve significantly and provide better chance for business growth (Van der Aalst 2016). The collected information are objectively compiled in process mining. At the end of the day, process mining procedures are useful on the grounds that they accumulate data about what is really occurring as per an event log of a business, and not what individuals believe is going on in this company.

Figure 3: Process Mining Application Scenarios

(Source: Created by Author)

The figure 3 illustrates the scenarios for using the process mining technologies. The process mining can be employed through either before or after the deployment of organization wide ICT system (Van der Aalst 2015). In the primary situation, the event logs are gathered physically. Process mining can be utilized to mine a process model, (for example, process perception) from a given log and think about the practices of the mined model with the given log, (for example, conformance testing). In the second situation, process mining can be utilized also aside from that the event logs are recorded by data systems naturally. Additionally, we can contrast the mined process model and the predefined one to discover the inconsistencies between them, (for example, delta examination).

Process mining is helpful for no less than two reasons. As a matter of first importance, it could be utilized as a device to discover how individuals or potentially methodology truly function. Taken as an example, business processes supported by an ERP ICT system such as SAP (like a purchase procedure). These kind of systems logs entire exchanges yet as a rule does not implement a particular method for functioning (Rosemann and vom Brocke 2015). Within like a domain, process mining may be utilized for picking up understanding within the authenticated procedure. Alternative situation would be the number of patients in a Hospital or Health Care Organization. It is to be noted that, taken as an instance, condition entire exercises are logged however, data regarding the fundamental procedure is regularly absent. Within this setting pressure that database administration systems give information regarding key functioning pointers like asset usage, stream periods and management levels (Partington et al. 2015). However, does not concern about the unknown business processes, taken as an instance, fundamental relations, demanding of functions and that is only the bottom of the concerned topic. Second, process mining may be employed regarding Delta Investigation, taken as an instance, contrasting the real process and few of the predefined procedures. A model this determines the functioning capability of individuals and associations based on various anticipated factors. By looking at the inflexible or unique process model with the freshly developed BPMN model, contradictions among both can be recognized and utilized for improving the procedure (Nguyen et al. 2014). Taken for instance, the developed reference models with regards to SAP. The developed models represent the utilization of the system. Utilizing process mining it is conceivable to check whether this is the situation. Truth be told, process mining could likewise be utilized to look at changed offices/associations utilizing the same ERP system. In the context of business process intelligence or BPI, the process mining is considered as one of the crucial tools.

Bose, R.J.C., Van Der Aalst, W.M., Zliobaite, I. and Pechenizkiy, M., 2014. Dealing with concept drifts in process mining. IEEE transactions on neural networks and learning systems, 25(1), pp.154-171.

Nguyen, H., Dumas, M., La Rosa, M., Maggi, F.M. and Suriadi, S., 2014, October. Mining business process deviance: a quest for accuracy. In OTM Confederated International Conferences” On the Move to Meaningful Internet Systems” (pp. 436-445). Springer, Berlin, Heidelberg.

Nguyen, H., Dumas, M., ter Hofstede, A.H., La Rosa, M. and Maggi, F.M., 2017, June. Mining business process stages from event logs. In International Conference on Advanced Information Systems Engineering (pp. 577-594). Springer, Cham.

Partington, A., Wynn, M., Suriadi, S., Ouyang, C. and Karnon, J., 2015. Process mining for clinical processes: a comparative analysis of four Australian hospitals. ACM Transactions on Management Information Systems (TMIS), 5(4), p.19.

Polyvyanyy, A., Smirnov, S. and Weske, M., 2015. Business process model abstraction. In Handbook on Business Process Management 1 (pp. 147-165). Springer, Berlin, Heidelberg.

Rojas, E., Munoz-Gama, J., Sepúlveda, M. and Capurro, D., 2016. Process mining in healthcare: A literature review. Journal of biomedical informatics, 61, pp.224-236.

Rosemann, M. and vom Brocke, J., 2015. The six core elements of business process management. In Handbook on business process management 1 (pp. 105-122). Springer, Berlin, Heidelberg.

Sonnenberg, C. and Bannert, M., 2015. Discovering the effects of metacognitive prompts on the sequential structure of SRL-processes using process mining techniques. Journal of Learning Analytics, 2(1), pp.72-100.

Van der Aalst, W., 2016. Process discovery: An introduction. In Process Mining (pp. 163-194). Springer, Berlin, Heidelberg.

Van Der Aalst, W.M., 2015. Business process simulation survival guide. In Handbook on Business Process Management 1 (pp. 337-370). Springer, Berlin, Heidelberg.

Van der Aalst, W.M., 2015. Extracting event data from databases to unleash process mining. In BPM-Driving innovation in a digital world (pp. 105-128). Springer, Cham.

What Will You Get?

We provide professional writing services to help you score straight A’s by submitting custom written assignments that mirror your guidelines.

Premium Quality

Get result-oriented writing and never worry about grades anymore. We follow the highest quality standards to make sure that you get perfect assignments.

Experienced Writers

Our writers have experience in dealing with papers of every educational level. You can surely rely on the expertise of our qualified professionals.

On-Time Delivery

Your deadline is our threshold for success and we take it very seriously. We make sure you receive your papers before your predefined time.

24/7 Customer Support

Someone from our customer support team is always here to respond to your questions. So, hit us up if you have got any ambiguity or concern.

Complete Confidentiality

Sit back and relax while we help you out with writing your papers. We have an ultimate policy for keeping your personal and order-related details a secret.

Authentic Sources

We assure you that your document will be thoroughly checked for plagiarism and grammatical errors as we use highly authentic and licit sources.

Moneyback Guarantee

Still reluctant about placing an order? Our 100% Moneyback Guarantee backs you up on rare occasions where you aren’t satisfied with the writing.

Order Tracking

You don’t have to wait for an update for hours; you can track the progress of your order any time you want. We share the status after each step.

image

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

image

Trusted Partner of 9650+ Students for Writing

From brainstorming your paper's outline to perfecting its grammar, we perform every step carefully to make your paper worthy of A grade.

Preferred Writer

Hire your preferred writer anytime. Simply specify if you want your preferred expert to write your paper and we’ll make that happen.

Grammar Check Report

Get an elaborate and authentic grammar check report with your work to have the grammar goodness sealed in your document.

One Page Summary

You can purchase this feature if you want our writers to sum up your paper in the form of a concise and well-articulated summary.

Plagiarism Report

You don’t have to worry about plagiarism anymore. Get a plagiarism report to certify the uniqueness of your work.

Free Features $66FREE

  • Most Qualified Writer $10FREE
  • Plagiarism Scan Report $10FREE
  • Unlimited Revisions $08FREE
  • Paper Formatting $05FREE
  • Cover Page $05FREE
  • Referencing & Bibliography $10FREE
  • Dedicated User Area $08FREE
  • 24/7 Order Tracking $05FREE
  • Periodic Email Alerts $05FREE
image

Services offered

Join us for the best experience while seeking writing assistance in your college life. A good grade is all you need to boost up your academic excellence and we are all about it.

  • On-time Delivery
  • 24/7 Order Tracking
  • Access to Authentic Sources
Academic Writing

We create perfect papers according to the guidelines.

Professional Editing

We seamlessly edit out errors from your papers.

Thorough Proofreading

We thoroughly read your final draft to identify errors.

image

Delegate Your Challenging Writing Tasks to Experienced Professionals

Work with ultimate peace of mind because we ensure that your academic work is our responsibility and your grades are a top concern for us!

Check Out Our Sample Work

Dedication. Quality. Commitment. Punctuality

Categories
All samples
Essay (any type)
Essay (any type)
The Value of a Nursing Degree
Undergrad. (yrs 3-4)
Nursing
2
View this sample

It May Not Be Much, but It’s Honest Work!

Here is what we have achieved so far. These numbers are evidence that we go the extra mile to make your college journey successful.

0+

Happy Clients

0+

Words Written This Week

0+

Ongoing Orders

0%

Customer Satisfaction Rate
image

Process as Fine as Brewed Coffee

We have the most intuitive and minimalistic process so that you can easily place an order. Just follow a few steps to unlock success.

See How We Helped 9000+ Students Achieve Success

image

We Analyze Your Problem and Offer Customized Writing

We understand your guidelines first before delivering any writing service. You can discuss your writing needs and we will have them evaluated by our dedicated team.

  • Clear elicitation of your requirements.
  • Customized writing as per your needs.

We Mirror Your Guidelines to Deliver Quality Services

We write your papers in a standardized way. We complete your work in such a way that it turns out to be a perfect description of your guidelines.

  • Proactive analysis of your writing.
  • Active communication to understand requirements.
image
image

We Handle Your Writing Tasks to Ensure Excellent Grades

We promise you excellent grades and academic excellence that you always longed for. Our writers stay in touch with you via email.

  • Thorough research and analysis for every order.
  • Deliverance of reliable writing service to improve your grades.
Place an Order Start Chat Now
image

Order your essay today and save 30% with the discount code ESSAYHELP