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IAB320 Business ProcessImprovement
创建日期：2024-07-05 17:10:19
标签： IAB320
Business ProcessImprovement
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IAB320 Business ProcessImprovement
Analysis of Business Processes
The aim of the 2nd assignment is to get familiar with the analysis of business processes.
Objectives:
O1. Increase your awareness for the challenges related to business process redesign.
O2. Apply the principles of business process redesign.
O3. Use process redesign approaches to fix issues in business processes.
O4. Demonstrate knowledge of process redesign approaches.
O5. Complete redesign tasks independently and within groups.
O6. Appreciate the social and organisational impacts of Process Redesign projects and effectively.
O7. Communicate your findings to stakeholders.
O8. Work effectively in team leadership roles in team projects.
1 Key Information
Group size: at most 4 students
Deadline: 27 October 2023, 23:59 (AEST)
Suggested page limit: at most 25 pages (excluding Title page, abstract, table of content, references &
appendices)
Weight: 30%
Submission: One PDF file + .bpmn (redesigned process) file per group on Blackboard
Questions: contact the teaching team during the tutorials, support sessions or via email:
• Dr Rehan Syed ( [email protected])
• Rob McMullen ([email protected])
2 The Assignment
Working in groups of at most four (4) students, you are asked to redesign the Health Insurance Claims Handl
ing process of 360-Degree Insurance as described in Section 3 and verify if the redesign will be beneficial.
You should deploy the following techniques:
1. Heuristics Process Redesign
2. BPR principles
3. Queueing theory
4. Simulation
Moreover, you need to consolidate the change option in a PICK chart along the dimensions of impact and
cost.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
Page 2 of 9
You need to produce a short report (not exceeding at most 25 pages (including everything) pages including
all figures), which includes the above items. An example report structure is shown in Section 4. See the
Marking Criteria in Section 5 for how we'll grade your assignment.
2.1 Handing-in
Please first register your group on Blackboard, and then submit the report as one PDF on Blackboard. Put
the names and student numbers of all students on the first page.
DECLARATION
By submitting this assignment, I am/We are aware of the University rule that a student must not act in a
manner which constitutes academic dishonesty as stated and explained in the QUT Manual of Policies and
Procedures. I/We confirm that this work represents my individual/our team’s effort, I/we have viewed the
final version and does not contain plagiarised material.
# Full Name Student No. Contribution Signature
1
2
3
4
2.2 Other things...
For anything else regarding the unit and assignments, please refer to the study guide on Blackboard. In
addition to the rules stated in the study guide, please observe the following:
• This is a 100% group assignment, and you are expected to work as a cohesive team.
• Some teams may have had non-contributing members.
• Close to the deadline, other students had to take over their work, on top of their own contribution
to not sacrifice their grade. Do not put yourself into such a position and start (& finish) the
assignment well before the deadline.
• The teaching team will only assist you up to one week before the deadline. Thanks.
3 Scenario
3.1 Health Insurance Claims Handling at 360-Degree Insurance
The insurance company 360-Degree Insurance as result of the process analysis that you conducted is now
aware of several issues affecting their core business process. In particular, they acknowledge that their
process is extremely inefficient and slow. To begin with, they are executing a lot of activities that are not
beneficial for the company, and that on the other hand, are only introducing extra costs.
In addition, during the handling of a claim, a lot of waste is produced due to handover of work between
employees (which causes the average time of the following activity to be 20% greater than needed), delays
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
Page 3 of 9
caused by unresponsive customers and health providers, and excessive processing of claims which often
leads to rejections. Finally, they also realised that their senior claim handlers are over-utilised and result in
being bottlenecks for the entire process.
Due to all these issues, the company lost almost 70% of its customers. To prevent further losses, 360-Degree
Insurance decided to start a redesign initiative and placed you in charge of it. The following section
describes (same as assignment 1) the current insurance claims handling process at 360-Degree Insurance.
The process starts when a customer lodges a claim. To do so, the customer fills in a form including a 2-page
questionnaire describing the issue. The customer can submit the form physically at one of the branches of
360-Degree Insurance, by postal mail, fax or simply via e-mail (digitally signed document).
When a claim is received, a junior claims officer first reviews the claimants claims history to ensure a
duplicate claim has not been lodged. Next, the junior claims officer enters the claim details into the
insurance information system. Data entry usually takes 25 minutes. The same junior claims officer performs
a basic check to ensure that the customer’s insurance policy is valid and that the type of claim is covered by
the insurance policy. This operation takes on average 30 minutes. It is rare for the claim to be rejected at
this stage (it only happens in 7% of cases), in case of a rejected claim the customer is notified about the
rejection (operation that takes 15 minutes). Otherwise, the claim is marked as “eligible” and moves forward
in the process. Next, the claim is moved to a senior claims officer who performs an in-depth assessment of
the reported issue and estimates the monthly benefit entitlement (i.e., how much monthly compensation is
the claimant entitled to, and for what period of time). This operation takes on average 2 hour.
In the case of short-term benefits, the senior claims officer can perform the benefit assessment without
requiring further documentation. In these cases, the assessment is straightforward (despite tedious) and
takes 45 minutes. As part of the benefit assessment, the senior claims officer also checks if the claim is
associated with an issue for which there is already an ongoing payment. A positive result to this check
results in a desk reject (which occurs in 4% of the cases). Once a decision is made, the senior claims officer
registers the entitlement on the insurance information system and informs the customer of the outcome via
e-mail or postal mail.
However, in the case of long-term claims (more than three months), the senior claims officer requires a full
medical report in order to assess the benefit entitlements. Senior claims officers perceive that these medical
reports are essential in order to assess the claims accurately and to avoid fraud (which only occurs in 3% of
the cases). Once the senior claims officer has received the medical report, they can assess the benefits in
about one hour on average. The senior claims officer then sends a response letter to the customer (by email and post) to notify the customer of their monthly entitlement and the conditions of this entitlement
(e.g., when will the entitlement be stopped or when is it due for renewal). The entitlement is recorded in
the insurance Information System.
Later, a finance admin triggers the first entitlement payment manually and schedules the monthly
entitlement for subsequent months. The finance admin takes on average 30 minutes to handle an
entitlement. Finance admin handle payments in batches, once per working day.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
Page 4 of 9
When a medical report is required, a junior claims officer contacts the customer (by phone or e- mail) to
notify them that their claim is being assessed, and to ask the customer to send a signed form authorizing
360-Degree Insurance to request medical reports from their health provider (hospital or clinic). Health
providers will not issue a medical report to an insurance company unless the customer has signed such an
authorization. In general, the authorization is received within 5 days from its request (requesting it only
takes 05 mins), despite in 2% of the cases the customer does not provide the authorization and after a
waiting period of 14 days the claim is withdrawn.
Once the authorization has been received, the junior claims officer sends (by post) a request for medical
reports to the health provider together with the insurer’s letter of authorization, requesting the medical
report takes on average 25 minutes. Hospitals reply to 360-Degree Insurance either by post or in some
cases via e-mail. On average, it takes about 14 working days for 360-Degree Insurance to obtain the medical
reports from the health provider (including 3 working days required for the back-and-forth postal mail). This
average however hides a lot of variance. Some health providers are very cooperative and respond within a
couple of working days of receiving the request. Others however can take up to 30 working days to respond.
As a result, the average time between a claim being lodged and a decision being made may take several
days. Naturally, so long waiting times cause anxiety to customers. In the case of long-term claims, a
customer would on average call or send an e-mail enquiry twice, while the claim is being processed. Such
enquiries are answered by the junior claims officer, and it takes about 10 minutes per enquiry. In about a
third of cases, junior claims officers end up contacting the health provider to enquire about the estimated
date to obtain a medical report. Each of these enquiries to health providers takes 10 minutes to a junior
claims officer.
The total benefit paid by the insurance company for a short-term issue is AUD$ 5K (typically spread across 2
or 3 months). For long-term issue, this amount is 30K, but some claims can cost up to 45K to the insurance
company. In case of long-term issue, the duration of the benefit (number of months) cannot be determined
in advance when the claim is lodged. In these cases, the benefit is granted for a period of 3 months and the
entire process is repeated (a new claim needs to be submitted) to determine if the benefit should be
extended. It often happens that the renewal takes too long, and customers stop receiving their monthly
benefit temporarily during the renewal process.
The insurance company receives 2855 claims per year (including resubmitted claims), out of which 25% are
for short-term issue and 75% for long-term issue.
The company employs three full-time junior claims officers, two full-time senior claims officers, and one fulltime financial officer. Their salaries are respectively $65,000 pa, $80,000 pa, and $95,000 pa. The
employment contact requires a full-time employee to works 8 hours a day (including 45 minutes unpaid
lunch break).
Finally, Figure 1 contains model of their “Health Insurance Claims Handling” process.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
Figure 1: The health insurance claim process of 360-Degree Insurance.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
4 Example report structure (your report MUST include the following
sections)
• Cover page
• Executive summary
• Table of contents
1. Process redesign
Present the results of the redesign: for each change applied, justify the change via the redesign
heuristics or the BPR principles.
2. Queueing Theory
Compare queue length of the current AS-IS process with the expected queue length of the TOBE process assuming zero delays. Limit your analysis to a single server (M/M/1)
3. Simulation
Compare the performance of the AS-IS process with the expected performance of the TO-BE
process and highlight the points of improvement.
4. Change Option Consolidation
Consolidate all the issues in a PICK (Possible, Implement, Challenge, Kill) chart.
5. Conclusion
Based on the above results, provide a well-structured summary on how to solve the issues
affecting the business process in the scenario.
6. References (APA Style)
7. Appendices
Please include all calculations in this section
Please ensure that your .bpmn file is attached
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
5 Report Formatting Requirements
5.1 Guidelines for using Headings.
Please use the number headings format (see example)
1.0
2.0
…
Level 1
1.1
1.2
….
Level 2
1.1.1
1.2.1
…
Level 3
1.1.1.1
1.1.1.2
1.2.1.1
...
Level 4
5.2 Page margins.
25mm (top), 25mm (bottom), 25mm (left), 25mm (right)
o All tables and figures must be captioned. Sources (if applicable) must be provided.
5.3 Font
o Calibri or Times News Roman
5.4 Referencing
o Please use APA for all intext citations and referencing
o Additional information is available at the following link
 https://www.citewrite.qut.edu.au/cite/qutcite.html#apa
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
1 Marking Criteria
This is a draft of the marking criteria we will use to mark the first assignment, to give an idea what we’re looking for. If multiple boxes could apply, we generally
choose the leftmost one. The points sum to 100 and count for 30% towards the unit score.
Criterion Weight 0%-24% 25%-49% >50% >65% >75% >85%
100 The Analysis achieves NONE of the
following
The Analysis achieves FEW ofthe following The Analysis achieves SOME of thefollowing in
a Satisfactory Way
The Analysis achieves SOME of
the following in an Appropriate
Way
The Analysis achieves MOST of the
following in an Effective Way
The Analysis achieves ALL of the
following in a Highly Effective Way
Format of report:
The report should be
presented in a professional
manner and without spelling
and grammar errors. All
tablesand figures must be
clear, well organised and
embeddedinto the flow of
the argument.
3 • Written expression and
presentation are incoherent,
withlittle or no structure, well
below the required standard
· Structure of the document isnot
appropriate and does not meet
expectations for a projectreport.
· Structure of the document needs some fine
tuning but is sufficient and meets some of the
expectationsfor a project report.
· Structure of the document is
appropriate and meets most
expectations for a projectreport.
· Structure of the document is
appropriate and meets
expectations for a projectreport.
· Structure of the document is
appropriate and meets expectations
for a project report well.
· Meaning unclear as grammar and/or spelling
contain frequenterrors.
· Meaning apparent, but languagenot always
fluent.
· Language mainly fluent, but some
minor areas that may lead to
confusion.
· Language fluent. · Clarity promoted by consistent use
of standard grammar, spelling and
punctuation. No errors.
· Disorganised or incoherentwriting. · Grammar and/or spelling containerrors. · Grammar and spelling mainlyaccurate. · Grammar and spelling accurate.Few
errors.
· Sentences skilfully constructed:
unified, coherent,forceful, varied.
· Required references are frequently
missing. The APAstyle is not appropriately
applied.
· Occasional inappropriate vocabulary,
style or tone forprofessional writing.
The tone and style of writing are
generally appropriate but may be
informal or conversational at times.
· Professional presentation. · Paragraph structure effectively
developed.
· Occasional unprofessional,untidy, or
unattractive presentation.
· Neat and tidy presentation. · Key statements are justified by
references as required. The APA
reference style is used with
minimal (at most one to two)
formatting errors.
· Fluent, professional style andtone
of writing.
· A reference list and in-textcitations are
included; somecitations/ related citation
information are missing.
· APA style is used for references and
in-text citations; some additional
supporting citations arerequired.
· Polished professional appearance.
· All key statements are justified by
references as required. APA reference
style is used without any formatting
errors.
Executive summary: The
executive summary has to
provide a stimulating
introduction. It should
include the key findings and
be at the right abstraction
level, i.e. not be just on a
metalevel (“This report will
discuss. . . ”).
4 · No Executive Summary written. · Executive Summary written but none of the
essential aspectscaptured.
· Writes an Executive Summary without
capturing all the essentialaspects of the
project or outcomes.
· Executive summary clearly captures
all the essential aspects ofthe project
and its outcomes.
· Executive Summary is
systematically, comprehensively
and succinctly presented.
Demonstrates independent
thinking.
· Executive Summary is
systematically, comprehensively
and succinctly presented.
· Demonstrates independent and
insightful thinking.
Introduction: The
introduction should
contextualise the company,
illustrate the purpose of the
report in a well-structured
manner. It should conclude
bypresenting the structure
of the report.
4 · Little or no clear: introduction,
topic, audience or relevant context.
Very hard to read and comprehend
Project goals and promised
deliverables are not articulated at
all. Poor contextualisation, where
prior work is not integrated at all to
support study motivation.
· General, unclear introduction. · Introduction gives some indication of the
scope of the work but requires further
development. Project goals and promised
deliverables are vaguely articulatedwith little
link to the overall context.
· Introduction provides general
indication of the scope of the work.
Goals and promised deliverables are
articulated but not made very clear
and are weakly linked to the context
provided.
· Introduction outlines purpose,
objective and scope of the work.
Goals and promised deliverables are
articulated in a manner that can be
understood by a broader
readership.
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CIVL2010 ECMT2150 CS 333 CP1406 KIT308 Economics 701 ECON3740 ECE 5759 BFC3340 FINC2012 COMP4500 MATH3871 FIT3080 18-819C Economic ECO202Y5Y PHY100 FINC-780 Econ 100B EC602 IE582 EE450 COMP9517 WRDS 150B ECON 570 LECTURE 2 ECA5101 ECE 4420 ADAD9311 FIT3031 CS 544 MF 703 CS 6140 KIT501 ENGSCI 344 CSC171 IE 332 FINM8007 21S2 COSC 1114 FE545 E471 SIT102 CSC108 MAT301 IAE 101 COP3503 STAT2004 EC 303 CS1026 STAT1203 MATH3171 ISOM5160 IFN657 FIT2014 ACCT2102 DSCI550 STATS 330 ELEC421 COMP3670 QBUS6840 MEES:698B MAST30027 MIET1077 Economics IFT 6758 FIT5122 BUSN5101 CptS 111 HRMT5502 Math2018 PP 312 INFS3200 CZ3005 CSSE1001 SENG 2011 MKTG 553Q BUFN 640 COMP507 ETF5952 DATA 311 ECE4043 BANK3011 finance M3H623544 HW1 INFS 7410 AI6103 STAT3888 INFS3208 ACCT7103 ECOS3013 PSYCH 20B F79MA STAT3006 ENGG952 2X MGSC 7000 ECE4132 MSF 526 MATH 3033 CDS 511 EEEE4120 EEET2465 ECA5103 MATH2070 ELEC3104 BU51019 EEE8147 ENGR20003 COSC 1107 ETF3200 FNCE 435 MSFI 435 ISyE6420 GENG4405 HW ETC5523 IE 7315 MOEC0021 STA 106 ENGG 1300A ENGG 1300 OLET1139 STAT 3503 STAT 206 FEM11149 ELEN 4720 COMP20003 SOLA1070 CS574 C11CS LINB29H3 MAST90083 ECON7200 STAT 610 LINB29 DSM-5 COMP3161 EEEN40010 MATH 4431 K353 STA 3386 IERG4300 COMS W4167 ENG5298 AMME 2302 CS3910 COMPSCI 320 STATS 369 GR5242 COSC 328 CSCI435 MGTS1301 INFS2200 COMP3900 CIS 375 Module AE03 COMP3121 CS260 HAM503 MGMT5050 INT3075 COSC 285 GEOL0029 GEGE2X01 STAT1201 MATH1061 MMF1941H STAT 5060 CS 520 COMP 4320 MSIN0104 000T FINS3648 ECMT2160 ECON4003 Phys 129L CSE 142 CS 3130 MGEB01 EECS 340 Finance (20443/20444) ECMM149 COMP5310 EEEN60180 CSC 111 AT2 CSCI 4430 STAB57 MA/CSC 427 MATH322 D100 CSCI544 CITS3004 CI6227 CSE 565 APCO 1P01 852L1 ELEC S411F COMP3207 STATS330 ECON7530 FIT5149 CSI4104 CMPT 371 COMP201 SEHS4696 FI4003 MATH6182 CG1 WS MATH401 MGT 205 QTM 110 COMP 0137 MACE12201 FIT5210 ECE 544 BISM7206 HUDM 6055 ECON3203 STATS 210 MSCI 570 MATH6173 COMPSCI4039 Accounting COM3503 AOE2024 ECON213 PSYC10004 Control Data 100/200A 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