Addressing the Benefit Claims Process Challenge

Published On June 12, 2020

What size impact is the COVID-19 pandemic having on the state agency benefit claims processes?  A big impact, according to Mary Ellen Buzzelli, Director of State, Local and Education Strategy for Iron Mountain Government Solutions. In an interview with Buzzelli she addresses the challenges — including legacy environments and remote workers — that state agencies are facing when processing an unprecedented volume of benefit claims requests.  

Q: COVID-19 is disrupting operations across the globe, what are some of the key challenges facing state agencies in the U.S. during this time?

A: State agencies are facing an unprecedented volume of benefit claims requests in a short timeframe. For example, as of May 23 the total number of new and continued unemployment claims stands at over 20,000,000 nationwide. Most of these claim systems are running on legacy environments, some of which are 60 years old.  In fact, according to Michele Evermore, senior policy analyst for the National Employment Law Project, only 16 states have fully modernized unemployment systems. The influx of claims – not just unemployment, but for all benefit programs – combined with the legacy nature of the systems they are running, puts these agencies in a situation where they are working through an extremely long backlog for citizens that need these benefits more than ever. This has been wreaking havoc on the entire benefit claims process. 

Q: What else are these agencies facing?

A: Given the fact that – even in today’s digital world – benefit claims processes require the submission of paper-based documents, the current work-from-home structure is not conducive. Although many submissions can be completed online, supporting documentation is generally paper based. In today’s COVID-19 environment, these supplemental documents are being mailed into agencies that have limited in-office support. And, the fact remains that agencies still, for the most part, print and store these claim forms and associated records in physical form on the backend.  With the large volume of paper and data needed to support the claimant management system and process, how can agencies safely and effectively do their job?

Q: What can our industry do to help support agencies?

A: At Iron Mountain, we can help with the pick-up and transportation of physical documents being sent into government agency offices. From there, we can provide digitization to enable access to critical business information; cloud Services to provide secure transfer of electronic images to an Enterprise Content Management system; secure storage of both physical and digital records; and destruction to ensure physical records are securely destroyed as required.

Q: So, how can agencies set themselves up for future success?

A: Agencies should use this crisis as an opportunity to deploy more modern records and information management programs that will enhance the delivery of services to citizens. This revolves around implementing information governance frameworks that enable agencies to use their information more effectively and ultimately drive more insights from it. In order to do so, agencies need to follow a process that includes:

• Assessing what they have and where it is located
• Prioritizing what needs to be accessed most often
• Inventorying all of the records and information
• Capturing that inventory
• Integrating workflow automation to more effectively leverage the information
• Deploying technologies such as artificial intelligence to generate insights
• Applying security protocols to protect the information

With a formal process in place, agencies will have a more effective information management lifecycle program that will drive their benefit claims processing systems going forward.

Q: Is there anything else we should know about the claims processing issue?

A: While the majority of benefit claims flow through a state’s platform and auto-adjudicate, a large volume of exceptions can easily consume existing staff. This is true whether you are dealing with unemployment, the Children’s Health Insurance Program (CHIP), Medicaid, SNAP food stamps or any other government-issued benefits program. As such, it is essential that agencies adopt new approaches to help set them up for near-term and long-term success, while delivering the best services to their citizens.