The Elsmar Cove Wiki More Free Files The Elsmar Cove Forums Discussion Thread Index Post Attachments Listing Failure Modes Services and Solutions to Problems Elsmar cove Forums Main Page Elsmar Cove Home Page
Google
  Web Elsmar.com
*Please be aware that SOME RECENT forum threads may not yet be indexed by Google.

View Full Version : Need DETAILED Procedure Template for Dental Insurance Co.


Kristy
12th December 2006, 12:33 PM
I need a template, form, or outline which will help me create a very detailed procedure manual. It has to include step by step directions for each employee and their daily, weekly, monthly, yearly tasks. It has to be so detailed that anyone could walk into that position and follow the steps to complete those tasks. This is for a dental insurance company. The president asked for this a year ago and no one ever created what he wanted. I've only been here 3 months and I've been chosen as this Project's manager. Lucky me! :mg: :censor:

CarolX
12th December 2006, 01:09 PM
Hi Kristy and Welcome to the Cove-

I see from you regitration that you are looking for

"Free policy & procedure manual for a dental insurance company. I am in charge of putting it together."

You can find examples of how folks here have addressed different processes and how those were documented - but a policy manual on how to run your business - I'm sorry to say it doesn't exist. Sure - there a folks that will sell you "canned" procedures - written so generically that they tell you nothing. Only you and your company can accurately detail out your process in a format that is usable for your employees.

Kristy
12th December 2006, 01:17 PM
Hi Carol - Thanks for replying. I know each company has it's different procedures, but what I'm looking for is just an outline template to follow in order to create the procedure manual. I've created something similar before but it was pertaining to only one position, not 9 employees. :frust:

CarolX
12th December 2006, 01:30 PM
Hi Carol - Thanks for replying. I know each company has it's different procedures, but what I'm looking for is just an outline template to follow in order to create the procedure manual. I've created something similar before but it was pertaining to only one position, not 9 employees. :frust:

Can you use what you created before and modify it for the other positions? I would classify these as job descriptions.

I did a search to see if anyone from the insurance industry has posted questions similar to yours. The only one I could find is this.

http://elsmar.com/Forums/showthread.php?t=17642&highlight=insurance

And this is my template for my procedures.

SteelMaiden
12th December 2006, 01:37 PM
You may not find exactly what you were hoping to, but if you follow a process similar to this, you should be able to put it together for your company. This list is very basic, and you will see as you begin documentation where you might need to tweak it for your company.

You will need to identify every job (task) that is performed that you want to include.
Interview people doing said job to find out how they do it
Decide as a group (or dictatorship, if that works:o ) the "best" method
Document each task documenting things like:
why this task is performed
Where this task is performed
how often this task is performed
Is there any equipment that you must have to perform this task
are there any other documents that you need to (or may need to) refer to in performing this task
Step by step instructons, including a description of what to do at any point where the task may not be turning out as expected (control of nonconformities)

Try not to "over document"

Good luck.

Wes Bucey
12th December 2006, 01:44 PM
Lest we quibble over terminology here, what your boss describes would probably be considered work instructions for specific tasks by many. Procedures are normally reserved for a process which might have multiple tasks performed by separate folks.

That said, many such tasks in insurance companies and other operations which shuffle paper or data entry key strokes are usually accompanied by a work instruction, often aided by a form which requires each data point to be entered in a rational order of when the data might be received.

For example, a pre-approval form for a non-emergency procedure might logically contain policyholder name and policy number, his contact information, the healthcare professional's name and contact info.
Next, a "bingo card" list of typical procedures plus space for a procedure not covered in the bingo list. Followed by another bingo list of justifications for the procedure.

Instructions for the organization worker would include how to deal with a form where the procedure and/or its justification fell outside the bingo list (kick up to a specialist?)

Since the point is to make the tasks as interchangeable among employees as possible (without special training), then it would seem to follow the tasks have to be as mechanical and void of special knowledge as possible, forwarding "exceptions" to someone trained to make a reasoned decision.

My understanding is most complaints by policy holders and health care providers fall into two categories -

long delays in making routine responses
mindless denial of benefits which denials are later reversed after lengthy appeals processes.I presume the end goal of the boss is to reduce the lag time between start and completion of a task, most likely due to indecision or absence of a employee handling the task.

One of the fields you should explore which has a lot of advance in employees being able to handle a number of different interactions with customer and suppliers is called Customer Relationship Management (CRM)

BradM
12th December 2006, 02:56 PM
Are you an independent agency? I would think that most insurance organizations have documentation for you to start with.

Say you’re writing a direction for taking out the trash. Do you focus on how to hold the bag(s)? Do you get into how much to put in each bag-minimum/maximum? What about where to put it on the curb? Do they need to hold it out? What about if it’s raining? Blah blah blah. In actuality, the most important thing you needed to identify is how to tell recycle from trash. If you include everything, you have a twenty page doc on taking out the trash; no one will read it.

The point I am trying to make is people approach things totally different. It is an art to write short, to the point documents that cover just what they need. It will have to come from your organization.

Please help this boss understand he/she must support this activity. It’s not just something “someone else can do”.

This is my opinion:

1. Do some research on the general problem solving tools like PDSA, DMAIC, etc. They can provide an overview to your boss what this will take.
2. Identify the key areas that will require documentation. Are you familiar with the fish diagram and brainstorming activities? I think this will take a lot of time if done correctly, but will be the most beneficial. Find out first exactly what needs to be done before you start doing.
3. Get some help from the other employees; delegate and support your helpers.
4. Communicate with your boss what’s going on. Give some feedback on your progress. The frequency of this is yours to decide.
5. Either from existing documentation or from scratch, start identifying certain areas and generate your work instructions for that. I would start with something than trying to generate from scratch.
6. Communicate again with the boss how things are going, and the resources being used, etc. In my opinion, some compensation of some sorts will need to go to your team for taking the extra effort. Even a simple, sincere "thank you; this means a lot to me" from the boss can make a difference.
7. Keep a general composition of what you are doing, and add it to your resume. You doing some good stuff, and you may want that resume to be current if your boss turns on you J

The key to all this is your boss is serious about spending the $$ to make this happen.

Kristy
12th December 2006, 02:59 PM
Thanks... I'd appreciate any and all feedback! This is a great place with alot of knowledgeable members.:agree1: :thanks: :thanx: :applause:

Kristy
12th December 2006, 03:14 PM
:thanks: Are you an independent agency? I would think that most insurance organizations have documentation for you to start with.

Say you’re writing a direction for taking out the trash. Do you focus on how to hold the bag(s)? Do you get into how much to put in each bag-minimum/maximum? What about where to put it on the curb? Do they need to hold it out? What about if it’s raining? Blah blah blah. In actuality, the most important thing you needed to identify is how to tell recycle from trash. If you include everything, you have a twenty page doc on taking out the trash; no one will read it.

The point I am trying to make is people approach things totally different. It is an art to write short, to the point documents that cover just what they need. It will have to come from your organization.

Please help this boss understand he/she must support this activity. It’s not just something “someone else can do”.

This is my opinion:

1. Do some research on the general problem solving tools like PDSA, DMAIC, etc. They can provide an overview to your boss what this will take.
2. Identify the key areas that will require documentation. Are you familiar with the fish diagram and brainstorming activities? I think this will take a lot of time if done correctly, but will be the most beneficial. Find out first exactly what needs to be done before you start doing.
3. Get some help from the other employees; delegate and support your helpers.
4. Communicate with your boss what’s going on. Give some feedback on your progress. The frequency of this is yours to decide.
5. Either from existing documentation or from scratch, start identifying certain areas and generate your work instructions for that. I would start with something than trying to generate from scratch.
6. Communicate again with the boss how things are going, and the resources being used, etc. In my opinion, some compensation of some sorts will need to go to your team for taking the extra effort. Even a simple, sincere "thank you; this means a lot to me" from the boss can make a difference.
7. Keep a general composition of what you are doing, and add it to your resume. You doing some good stuff, and you may want that resume to be current if your boss turns on you J

The key to all this is your boss is serious about spending the $$ to make this happen.

:thanks: The boss is making a multitude of changes company wide and I was hired for my computer experience to upgrade the office and as an assistant to the Director of Marketing and Sales. We are an insurance Company, not an Agency. The problem lies with everyone that works here has been here since the beginning of time. None of the employees, except for myself and the director, knows anything about streamlining tasks. I work smart, not hard. I have been creating forms and spreadsheets for everything, takes a ton of time, but once everything is create and a system in place, it will be beautiful. I've created tracking logs which my boss can reference to get the information he needs immediately for his monthly reports. Before I came along, no one had tracked transactions. The people here are doing things the way they've been done since the beginning of time. It is still getting the job, but their procedures are so complicated... in other words they are not using the necessary equipment & software to make their jobs easier and much faster. The office wasn't even networked. I networked the entire office so we could share information. They don't know anything about new technology and I spend most of my day teaching simple steps; how to attach a file to an e-mail. It's like the office that time forgot :biglaugh:

My boss is setting up weekly meetings where I teach the office basic computer skills. He is very supportive and ready to move into the future :agree1:

I just don't think I will be very popular with my co-worker... being here only 3 months and making tons of changes that they must comply with...:eek:

BradM
12th December 2006, 03:56 PM
I just don't think I will be very popular with my co-worker... being here only 3 months and making tons of changes that they must comply with...

Very well stated!! Hence the reason the other posters stated some of the things they did. That is exactly why I suggested the boss is going to have to be behind this, and belly up with some compensation of some kind (not just money).

The only way you can change culture overnight is through upper management. Even then, they have to believe and cultivate the change until it becomes learned, practiced by the group, and becomes the norm. Otherwise, all will just go back to their wild and wooly ways.

Colpart
12th December 2006, 04:01 PM
Sorry to input some negative thoughts here but I do not think it is possible to document everyone's experience in form of procedures/work instructions.

All the best systems I have ever seen are a combination of documentation and competence of the people doing the job. Besides, has anyone thought about what your co-workers will be thinking? Perhaps something along the lines of "they want all my knowledge written down so they can fire me and bring in some cheaper people".

SteelMaiden
12th December 2006, 04:08 PM
I just don't think I will be very popular with my co-worker... being here only 3 months and making tons of changes that they must comply with...:eek:

Just remember that, according to your own statements, some of these people have been there since the beginning of time:tg: You will need to be careful about how you approach them to change what they have been doing. Being people, they need to see a purpose for the changes, and it has to be couched in terms that make them feel that they are being helped also, not just "the company". Change can be a very good thing, but a lot of people really fear it. It is easy coming into a situation with fresh eyes to see how dysfunctional a system is, but it is a system that these people have lived with for a long time. Instead of couching it in terms of "making tons of changes that they must comply with" these changes should be brought to them as changes that will make their lives easier and better in the long run. It is your job to be able to show them how that will work.:2cents:

Kristy
12th December 2006, 04:20 PM
Before "the meeting"... everytime I'd make a suggestion for improvement or try to show them a much easier way to get to the same end... they'd tell me... well... I'll just keep doing it this way because it's easier for me and that other stuff is too complicated... they are sooooooooooo against change :(

Coury Ferguson
12th December 2006, 04:24 PM
Before "the meeting"... everytime I'd make a suggestion for improvement or try to show them a much easier way to get to the same end... they'd tell me... well... I'll just keep doing it this way because it's easier for me and that other stuff is too complicated... they are sooooooooooo against change :(

Those are typical road blocks :frust: that happen to someone new trying to improve things and make them simpler.

May I suggest that you get them involved in writing these documents. Sometimes when people are involved, they tend to accept change easier. :)

Kristy
12th December 2006, 04:31 PM
Those are typical road blocks :frust: that happen to someone new trying to improve things and make them simpler.

May I suggest that you get them involved in writing these documents. Sometimes when people are involved, they tend to accept change easier. :)


Oh how I wish it would be that simple :bonk: I totally agree with you on that note :agree1:

However, they have been asked to do this several times and each person will write down very vague instructions that no one could follow...

My boss' worry is that if one person gets seriously ill or is in a fatal accident, is there someone that can at least perform enough of that person's duties to be able to keep things running??? Everyone of the employees said.. "NO"... This is very scary and something to think about... which is why he wants me to do what I'm doing.

He wants me to spend about 2 hours a day with one employee and document all procedures... continue with that person every day until I have everything documented... even if it takes a month or longer for one person... then move on to the next.

It really needs to be done... kind of like a safety net :tg:

Sidney Vianna
12th December 2006, 04:49 PM
However, they have been asked to do this several times and each person will write down very vague instructions that no one could follow...

My boss' worry is that if one person gets seriously ill or is in a fatal accident, is there someone that can at least perform enough of that person's duties to be able to keep things running??? Everyone of the employees said.. "NO"... This is very scary and something to think about... which is why he wants me to do what I'm doing.Obviously your co-workers are concerned with job protection. Exercises like you are undertaking are, many times, followed by lay-offs and hiring of a new workforce much cheaper than the ones they replace. Knowledge management is critical, but have your boss clearly and unmistakably stated that nobody will be let go after their processes get documented? If your boss does not make that commitment, people will always be suspicious of what is happening.

It really needs to be done... kind of like a safety net Not necessarily. People can get cross trained so, when someone is ill or absent for other reasons, co-workers can perform the processes.

What you are trying to accomplish is not easy. If people are suspicious of the motives, it will be mission impossible because they will sabotage the change management process. Good luck.

Wes Bucey
12th December 2006, 04:51 PM
Sounds to me like you and your boss also need an experienced "Change Manager" to help you get past the inertia and resistance from the current employees.

Take a quick look at these posts and the threads in which they occur:


http://elsmar.com/Forums/showpost.php?p=93888&postcount=22
http://elsmar.com/Forums/showpost.php?p=94443&postcount=2
http://elsmar.com/Forums/showpost.php?p=96039&postcount=4
http://elsmar.com/Forums/showpost.php?p=100120&postcount=8Then you might to want to begin a new thread on how to change the status quo mindset you have encountered.

SteelMaiden
12th December 2006, 05:01 PM
Your management needs to back you up and make sure that everyone understands the motives behind this project...assuming that management does not intend to sweep the floor clean of all the oldtimers to hire cheaper, inexperienced workers.:notme:

Kristy
12th December 2006, 05:03 PM
Obviously your co-workers are concerned with job protection. Exercises like you are undertaking are, many times, followed by lay-offs and hiring of a new workforce much cheaper than the ones they replace. Knowledge management is critical, but have your boss clearly and unmistakably stated that nobody will be let go after their processes get documented? If your boss does not make that commitment, people will always be suspicious of what is happening.

Not necessarily. People can get cross trained so, when someone is ill or absent for other reasons, co-workers can perform the processes.



Exactly... only one person here knows their procedures... if that person is out... it just doesn't get done until they get back. That.. in my opinion... is unacceptable... :nope: What I am putting together is for cross-training purposes. Example... if the end of the month is not processed... many people won't get paid... including MYSELF :mg: not to mention claims getting paid... and the agents that write for us.

BradM
12th December 2006, 05:04 PM
Sorry to input some negative thoughts here but I do not think it is possible to document everyone's experience in form of procedures/work instructions.

All the best systems I have ever seen are a combination of documentation and competence of the people doing the job. Besides, has anyone thought about what your co-workers will be thinking? Perhaps something along the lines of "they want all my knowledge written down so they can fire me and bring in some cheaper people".

Well said, and great points. That's why, from my perspective, the initial brainstorm session is critical here. There are some things you will never get documented. There is reasonably some room for improvement, but everything will not be captured. Too, the employees will need to feel a part of this.

If you could properly document taping and bedding (house construction), you wouldn't have to pay someone to do it.

I'm not sure where this boss is in all this. I'm not trying to be negative, but the boss has a Great Awakening ahead. It don't matter how much you yell, it's difficult to avert a stampede. This situation was not created overnight, and will not be fixed overnight.

Kristy
12th December 2006, 05:04 PM
Your management needs to back you up and make sure that everyone understands the motives behind this project...assuming that management does not intend to sweep the floor clean of all the oldtimers to hire cheaper, inexperienced workers.:notme:


:lmao: :thanx:

Kristy
12th December 2006, 05:13 PM
I'm not sure where this boss is in all this. I'm not trying to be negative, but the boss has a Great Awakening ahead. It don't matter how much you yell, it's difficult to avert a stampede. This situation was not created overnight, and will not be fixed overnight.


:applause: :agree1: AMEN!