Cognizant Technology Solutions

1

CPM-HC

Purpose
Built expressly for healthcare organizations, CPM-HC is a packaged business process
management solution that delivers multi-channel, intent-driven customer service to increase
productivity, loyalty and growth. CPM-HC provides intelligent inquiry case management,
automated work handoffs, seamless data and knowledge integration and CTI
functionality. Other features include automated case documentation, special handling alerts,
work monitoring, automated escalations, as well as enhanced integration, reporting and
analytics.
CPM-HC is typically used to service member and provider inquiries for multiple business lines
including Commercial, Medicare, Medi-Cal, and Direct Pay.

Customer Interaction Management

Customer interaction is a common requirement for any Call Center application. Every
interaction is aimed at providing service to the customer.

CPM is capable of handling customer service requests through multiple channels.



Fig. 1: Interaction Types


Interaction
Live
Telephone Branch Walk-in
Non Live
Correspondence Email
CTI
(Computer Telephony
Integration)


Cognizant Technology Solutions

2
A typical CPM application would have business processes group together based on the
type of service.

A trained user would select a business process from the appropriate service category.
E.g. CPM-HC provides standard categories like
Provider
Member
Contact
General

Note: Creation of categories for business processes is configurable and hence can be modified to meet
specific requirements.

A typical interaction involves the following actions
Identifying and verifying the customer
Processing service requests
Standard CPM business processes
Accessing customer information
Ending customer interactions




Fig. 2: Interaction Process Sequence





Cognizant Technology Solutions

3
Service flow / business process

Any existing business process can be translated into a CPM service workflow.



Fig. 3: Interaction driver screen.

The service workflows can be new / independent or it can be integrated with the legacy
and back-end system.



Cognizant Technology Solutions

4
Customer Interaction
Service Request1 Service Request3 Service Request2
Legacy System
R
e
a
l

t
i
m
e

d
a
t
a

u
p
d
a
t
e
R
e
a
l

t
i
m
e

d
a
t
a

u
p
d
a
t
e
R
e
a
l

t
i
m
e

d
a
t
a

u
p
d
a
t
e

Fig. 4: Interaction-Service relation

Every service request can have the following capabilities
SLA Management
Skill based routing
Correspondence generation

Queuing of Processes in the Interaction driver screen






Cognizant Technology Solutions

5
Suggested Processes list the processes that CPM has determined you may want to be
use during this interaction. The basis of the list is information on the caller, account
profiles, and recent history
Other Processes selection of a business processes from categorized lists. (Category
was explained earlier in previous topics)

Queued Processes list of processes queued for this interaction. In some cases, the
system may automatically queue business processes required during the interaction


360 or Composite View

Displays information about the customer in a tabbed format. Depending on the
implementation this may include tabs like Provider, Contact, Claims, and Authorizations
etc.




Information in the customer composite areas may come from the legacy processing
systems, from the CPM database, or from other third-party applications and databases
within the organization.

CPM provides the ability to refresh the composite data area during an interaction to
provide up-to-date information.




Cognizant Technology Solutions

6
Handling Non-Live Customer Interaction

Automatic Case Creation - CPM automatically creates non-live interaction cases for
inbound e-mail, fax, or correspondence inquiries depending on the system
implementation. CPM will:

Listen for inbound e-mails and faxes that arrive at designated folders and
automatically create inbound interaction cases. CPM routes these cases to the
Inbound Correspondence workbasket.

Automatically create cases for inbound mail correspondence through
integration with your companys imaging system. CPM routes these cases to the
Inbound Correspondence workbasket

Manual Case creation we can also create manual cases by feeding data provided by
the customer into various screens.

Non-live interactions are processed by identifying the type of service requested by the
customer and initiating the appropriate process from the Interaction driver screen.

Guided UI Experience

Dialog Scripts - The Dialog gadget displays suggested wording to use during the
customer interaction. Dialog text changes to match the specific business process related
to the interaction.




Cognizant Technology Solutions

7

Authorized business analysts and supervisors can change the dialog script during review
or processing of the interaction.

Creating and Assigning Coaching Tips - Coaching tips help improve employee
performance and reinforce best practices. Users with the appropriate privilege can
create coaching tips for any screen that is available in a live customer interaction.







Cognizant Technology Solutions

8
Sales and Marketing Functions

Campaign Management - The Campaign Management gadget enables managers and
supervisors to manage and monitor cross-sell, retention, restitution, and reward
campaigns.


Opportunity Processing - We can create opportunities in the context of a live or non-live
interaction, or as part of a research session. After we create the opportunities, sales
representatives, sales managers, and other authorized users can continue to work with
these opportunities.




Cognizant Technology Solutions

9
Help and Reference utilities

The Reference Utilities give access to the companys reference information, accessed
from icons at the top of the display.




Location Finder The Location Finder assists in providing address and phone
information to a customer.





Cognizant Technology Solutions

10
Reference Materials - Reference Materials gives users access to an online library of
product, service, and policy documentation and other informational resources that one
may want to consult during an interaction.




Knowledge Help - Knowledge help provides users with access to knowledge topics that
are recommended for a type of interaction or service process. This is similar to the
reference material but filtered for a specific type of work or process.




Cognizant Technology Solutions

11

CPM components






Cognizant Technology Solutions

12


Appendix

1. Creation of Ready Reckoner
2. Knowledge Gathering exercise from the Existing Projects.
3. Enhancements on the knowledge gathered (explore other unused features of frameworks)
4. Documentation of Challenges faced in the existing project to implement HCFW & Solution

Anupam Majumdar/Sylvia Das/Danish Yasser/other members of Framework exploration team