Need DETAILED Procedure Template for Dental Insurance Co.

K

Kristy

#1
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:
 
Last edited by a moderator:
Elsmar Forum Sponsor

CarolX

Super Moderator
Super Moderator
#2
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.
 
K

Kristy

#3
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

Super Moderator
Super Moderator
#4
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.
 

Attachments

SteelMaiden

Super Moderator
Super Moderator
#5
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:eek: ) 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

Quite Involved in Discussions
#6
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 -
  1. long delays in making routine responses
  2. 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

Staff member
Admin
#7
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.
 
K

Kristy

#8
Thanks... I'd appreciate any and all feedback! This is a great place with alot of knowledgeable members.:agree1: :thanks: :thanx: :applause:
 
K

Kristy

#9
: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

Staff member
Admin
#10
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.
 
Thread starter Similar threads Forum Replies Date
U How detailed do Procedures and Flowcharts need to be ISO 9000, ISO 9001, and ISO 9004 Quality Management Systems Standards 10
D Do all Non Conformance Reports need a detailed Root Cause Analysis? AS9100, IAQG, NADCAP and Aerospace related Standards and Requirements 13
J Work Instructions - How detailed do work instructions need to be? QS-9000 - American Automotive Manufacturers Standard 6
J Need a contract monitoring Tool General Information Resources 0
P UDI-PI requirements on reusable surgical device, do we need serialisation? ISO 13485:2016 - Medical Device Quality Management Systems 0
J Need Help with FPY Data in Assembly Process Manufacturing and Related Processes 7
W 17025 and NIST handbook relationship (need advice) ISO 17025 related Discussions 8
lanley liao Does all of the suppliers need to integrated into the supplier list qualified of the company? Oil and Gas Industry Standards and Regulations 2
K Need procedure for D&D inputs? ISO 13485:2016 - Medical Device Quality Management Systems 4
S Need help on "Country of Origin" Medical Device and FDA Regulations and Standards News 0
Ed Panek Immediate need for 80601-2-56 Consulting expert. PM me for details Career and Occupation Discussions 0
Tagin You're Gonna Need a Bigger Root Cause Coffee Break and Water Cooler Discussions 12
M PSA Suppliers - CSR matrix and need the quality manual of PSA APQP and PPAP 2
M Need Help With Information Security Asset Risk Register IEC 27001 - Information Security Management Systems (ISMS) 2
K "World Class Product" based QM. I need advice. Quality Management System (QMS) Manuals 14
I Do I need to sign off my annual audit calendar? Internal Auditing 2
P Do we need to retrospectively use the "MD" symbol (indicating device is a medical device) on labels, e.g. finished devices within expiration date? EU Medical Device Regulations 2
M Do I need separation in my circuit with a medical charger? IEC 60601 - Medical Electrical Equipment Safety Standards Series 0
V Certified Auditor - Need of additional certification specific to industry ( GMPs) ASQ vs ECA vs others Professional Certifications and Degrees 1
D Low risk IVD study in the UK, do I need MHRA approval? UK Medical Device Regulations 1
A Medical Device Contract Manufacturer - Does the CM need to register with FDA? 21 CFR Part 820 - US FDA Quality System Regulations (QSR) 3
J Records Control - Does each individual record need to be numbered? Records and Data - Quality, Legal and Other Evidence 2
N Is there a need for clinical test of Class IIa products (for MDR)? EU Medical Device Regulations 2
J Do Software Subcontractors need to be ISO13485 compliant in the EU? EU Medical Device Regulations 3
K Do I need a "State of the art" plan? CE Marking (Conformité Européene) / CB Scheme 1
S Need advice for schooling Quality Manager and Management Related Issues 5
R What information do i need to get from the device manufacturer 21 CFR Part 820 - US FDA Quality System Regulations (QSR) 0
S Need guidance on project ISO 13485:2016 - Medical Device Quality Management Systems 2
H Need MSA 4th ed. compliant attribute MSA template General Measurement Device and Calibration Topics 4
J Need Change Control Yes/No Decision Tree Template ISO 9000, ISO 9001, and ISO 9004 Quality Management Systems Standards 1
C Does an accessory need an IFU if it use is discussed in the Parent device IFU? 21 CFR Part 820 - US FDA Quality System Regulations (QSR) 5
B Countries with no need for FSC (Free sales certificate) Other Medical Device Regulations World-Wide 0
R The term "Benefit Risk Ratio" in EU MDR, do I need to present benefit risk analysis as a RATIO Risk Management Principles and Generic Guidelines 4
A Brexit When does the UK responsible person need to be in place? UK Medical Device Regulations 10
R Do we need issue ECN (Engineering Change Notice) towards updated Material Specification? Design and Development of Products and Processes 2
N IPC-A-630 - Is this free or do i really need to pay for it? Manufacturing and Related Processes 4
C ISO/ IEC 17021 Resource requirement (need help) Document Control Systems, Procedures, Forms and Templates 5
P Need a programmer for QVI's VMS software for optical inspection machine Inspection, Prints (Drawings), Testing, Sampling and Related Topics 0
silentmonkey How to decide what characteristics need to be verified during incoming inspection? ISO 13485:2016 - Medical Device Quality Management Systems 5
D Change Approval Requirements - Does every change need formal customer approval? Design and Development of Products and Processes 17
T Do I need a qualified compiler for class B software? IEC 62304 - Medical Device Software Life Cycle Processes 3
E 13485:2016, Sections 4.1.6, 7.5.6 and 7.6 - Validation of Software - Need some Advice please ISO 13485:2016 - Medical Device Quality Management Systems 3
C ISO 13485 :2016 - CAPA - Does every CAPA need to be checked by regulations? ISO 13485:2016 - Medical Device Quality Management Systems 9
L Proof of Concept Studies - Do we need to comply with SAE reporting? Medical Device and FDA Regulations and Standards News 3
gunnyshore Adding a new facility - do I need to submit an amendment to the MDL or MDEL, or both? Canada Medical Device Regulations 3
N FDA UDI - Label vs. Labeling - Does the insert need to include UDI? Other US Medical Device Regulations 1
SocalSurfer AS9100 new certificate, but need QMS software, help Quality Assurance and Compliance Software Tools and Solutions 2
A Demonstration of Equivalence - Need for comparing biological characteristics for an SamD EU Medical Device Regulations 1
G Need to change KPI we called NC parts (maximum 3%.) to FTQ (first time quality) IATF 16949 - Automotive Quality Systems Standard 4
W Need for current design or process control FMEA and Control Plans 2

Similar threads

Top Bottom