HCF Annual Report 2009

Review of Operations

HCF offers a range of products and services that provide the freedom for our members to choose and access high quality health care and financial services. We meet and exceed our members’ expectations through continued improvement in efficiency and service standards, meeting our pledge that HCF gives more for our members.

Making it Easy to Do Business with Us
During 2008/09 we invested significantly in improving our data centre technology, customer relationship management and dental centre systems.

The use of virtual server technology saved over $400,000 this year and our upgraded mainframe computer has improved our disaster recovery capabilities.

Electronic Commerce and Process Automation – Better service Lower costs

This year we processed 78% of all sales, service and claims transactions electronically. Major benefits were realised with the automation of medical claims processing.

HCF was the first fund in Australia to process hospital claims using the Federal Government’s ECLIPSE system. HCF has seventy participating private and public hospitals processing their claims through the ECLIPSE system. ECLIPSE has eliminated manual coding and reduced by half the claims error rate.

Our business intelligence systems have enhanced our ability to prevent improper claiming practices. Combined with our rules based claims engine it acts as an early warning system in detecting the risk of fraudulent claims.

Invoice scanning and data recognition using ReadSoft and integrated data enhancement and verification services will be extended to ancillary claims in 2009/10. This will enable claims data received through the mail to be automatically transferred to ACE (HCF’s automated claims processing engine) for assessment and payment.

A new scanning capture system will soon process membership applications automatically, eliminating manual tracking and distribution of membership forms, reducing processing time and improving data capture.

This year, 433 private hospitals used our online membership eligibility checking service for pre approval for 251,957 hospital admissions (about 90% of all admission enquiries). Seventy three percent of all hospital claims, 82% of all medical claims and 73% of all ancillary claims were processed electronically, providing significant saving for hospitals, doctors, ancillary providers, members and HCF.

We are also achieving savings across the organisation under our ‘Straight through Processing’ and Kaizen projects. These are re-engineering other high volume, core business processes and will be progressively implemented during 2009/10.

A patient management system was implemented across the dental centre network in December 2008. This was the largest implementation of such a system in the southern hemisphere, bringing improved quoting, stronger benefit controls, flexible appointments and assisting in the development of electronic services to our members. The system will enable dentists to access and update patient information at the dental chair using wireless technology.

We also introduced an over-the-phone automated credit card payment system. Our new Customer Relationship Management System to be installed in August 2009 and we expect it to reduce average call handling time by approximately 6 minutes and with waiting times to fall to around 2 minutes.

The HCF and MU Information Management teams assisted in the integration of MU data and applications with HCF. This has enabled MU members to have access to the HCF branch network and dental centres.