Corticon Helps States Manage Complex Workers’ Compensation With Less Cost and Effort

State workers’ compensation commissions face ever-shifting regulation, job growth and increasing complexity of claims, which makes it harder to serve citizens while keeping costs down.

In addition, workers’ compensation laws and regulations change constantly. In just the first six months of 2018, the National Council of Compensation Insurance (NCCI) tracked 86 new state and federal workers’ compensation laws and 83 regulatory changes.

Workers’ compensation departments need a way to improve the efficiency of managing and updating employer compliance, policy offerings, claims and appeals. States can streamline operations by automating more transactions, but IT departments often contend with complex, inflexible legacy systems, which stymy their efforts to modernize and make it difficult to keep up with regulatory changes.

In search of a solution, many state IT organizations have turned to Progress Corticon business rules management system (BRMS) to help speed development cycles while lowering cost and risk. Corticon simplifies the development and execution of nuanced rules for workers’ compensation, such as ensuring proper coverage, assessing reporting compliance, managing the state fund, handling claims, and more. With rules-driven automation carrying more of the workload, workers’ compensation departments can better serve the community while keeping the budget trim.

Progress Corticon shortens development time and cuts costs for essential transactions, including:

• Employer coverage compliance
• Reporting compliance
• State fund eligibility
• State fund claims management
• Second injury fund claims management
• Policy underwriting and pricing
• Appeals and reviews
• Audits

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Improve Efficiency and Ensures Consistent Performance

Business rules represent the logic required to automate part or all of workers’ compensation tasks. For example, business rules determine how much coverage an employer has to carry based on the number of employees, type of business, gross revenue and other factors. A BRMS application collects the data and applies the rules, responding with a decision, such as whether an employer is carrying enough insurance.

Shorten Development Cycles and Lower Costs

In many legacy systems, the business logic is hard-coded and spread out across applications. As a result, it takes extra time and effort to track down the right code and implement changes consistently and completely without impacting other operations.

A BRMS contains the logic in one application so rule modelers can quickly access and understand the full set of rules. They can make changes once and test to ensure against unintended consequences.

When it comes to new automation, a BRMS shortens development cycles because each added application doesn’t have to reinvent the logical wheel. The BRMS serves up consistent logical calculations to any system as needed.

Ensure Consistency and Compliance With More Flexible Architecture

When business rules are hidden in separate applications, the risk of inconsistency and improper implementation increases with each update. If different systems apply rules differently, it causes confusion and possible harm to the employees and employers states are trying to help.

Rules in a BRMS can be used by different client applications, such as backend business processes or frontend user interfaces. Changes are made in one place, so they operate consistently across all applications.

Maximize the Business Value of a BRMS

The Corticon BRMS is designed to maximize the business advantages of rules engines. Its design and interface emphasize flexibility, transparency and maintainability. In fact, Corticon customers are able to reduce time and effort of developing and maintaining automated systems by up to 90%.

Close the Gap Between the Business and IT

Corticon’s no-coding development environment puts business rules in the hands of the analysts who specialize in complex insurance and compliance rules. These experts can use Corticon Studio to model, test and deploy rules directly to the application server. Involving business analysts in application development shortens timeframes and reduces the risk of miscommunication between groups.

Reduce Costly Errors With Sophisticated Testing

Well-known research has shown that mistakes not caught until integration testing take 10 times more budget to fix than those caught during requirements. And mistakes that don’t surface until deployment can rack up 30 times the cost.

Corticon Studio includes a powerful testing environment, which insurance analysts can use to guarantee the rules are operating as designed. Studio provides tools for identifying logical conflicts and ensuring rules handle all realistic data scenarios. These tools can even catch mistakes hidden in traditional flow charts and requirements documents.

Minimize Maintenance Costs and Risk with Graphical Development Tools

As an application matures, the business and technical teams that built it will change. Traditional systems become unusable when those who designed them are no longer around and others can’t understand how they work or are unable to decipher spaghetti code.

Corticon encourages modelers to create maintainable rules with simple and accessible commenting features and a graphical user interface. A new team member can quickly understand rules written by others and build on what’s already done. Studio also supports the development of regression test suites that ensure new changes don’t impact existing logic.

Protect Investment With Flexible Architecture

Whether an IT group is well into architectural modernization or still working around legacy systems, Corticon BRMS can fit into any Java or .NET environment. This flexibility ensures that as IT groups update their systems, Corticon will stay relevant and continue to provide value.

Lower the Cost and Effort of Audits and Regulatory Compliance

Audits are an important but time-consuming task for workers’ compensation agencies. Corticon eases the burden of audits with a wide range of logging options including system diagnostics, timing logs, error logs and customized rule-triggered messaging.

Corticon Is the Proven Choice for 28 States

Across the U.S., 28 states have selected Corticon to handle transactions from health and human services to motor vehicle registration and licensing.

State IT departments must be able to manage large transactional volume with precision and consistency for a public that demands easy automation, fast responses and access to data. And when new legislations passes, they often have just days to implement changes. In addition, they need a system that can grow with their population.

Corticon’s usability, unparalleled performance, linear scalability and proven reliability make it the state choice for millions of mission-critical transactions every day.

There’s nothing like firsthand experience to help you determine if Corticon is right for your state. If you’d like to test drive Corticon’s powerful features, download a trial version or request a demo today.

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