Describe a transformation process

1. Describe a transformation process within an organization that is familiar to you; list all inputs, components, and the transformation process that produces either a product or service the organization delivers its customers. Make sure you mention all of the parts of the transformation process.

 

When considering a transformation process within an organization that is familiar to me, the first thing that comes to mind is a process that my current employer has implemented. This transformation process begins at the plan level and trickles down to the member as well as most healthcare providers. Initially, upon becoming active, a new member is issued an insurance card. The informatics department receives a file from the state during the last week of each month to process. Upon completing the date entry, the updated list is sent to the eligibility department to review and finalize. Once this process is complete, customer service would mail the new insurance cards to each new member. The members use this insurance card as proof of coverage and to receive healthcare services. Historically, members would receive their insurance card in the mail within 7-10 business days. For obvious reasons, the delay in the insurance card delivery method was less than ideal. As a matter of fact, the time frame would delay visits with providers, scheduled procedures, interruption in the release of medical supplies and/or medications. In some instances, the member would never receive their insurance card. This mostly was due to old addresses or invalid information. Ultimately, a percentage of members would never receive the mailing or even become aware of it. Also, the organization was utilizing resources to complete the initial mailings and then sort through any returns. The returned mail required many hours of manual labor to identify which members needed to be flagged for missing or wrong address. The organization went through many efforts to search different databases and progress notes in hopes of locating a different address than the one originally used. As a result, the transformation process was enhanced and aligned to meet the member needs and organizational goals. Part of the enhancement included digital access to view their insurance card information. The insurance card information is available through a secure online portal on the company’s website (Community Health Group, 2020). This transformation process made it simple and easy for members to have access with little to no delays in care. In addition, the mailings and returns became minimal, and wasted resources have been reduced. This process has been especially beneficial during this pandemic. A physical insurance card is no longer the only option for a member to present to the healthcare providers. The digital card can be downloaded and saved in most devices making this convenient for all.

Community Health Group. (2020). Member Access. Retrieved from: https://www.chgsd.com/members/my-access

2. What is the difference between a “products or goods” versus “services”? What are some of the similarities and differences between the two? Can services be inventoried? (Last Question is Lecture Based) Give some examples based upon your experience as a customer or from your professional experience.

1. Describe a transformation process within an organization that is familiar to you; list all inputs, components, and the transformation process that produces either a product or service the organization delivers its customers. Make sure you mention all of the parts of the transformation process.

 

When considering a transformation process within an organization that is familiar to me, the first thing that comes to mind is a process that my current employer has implemented. This transformation process begins at the plan level and trickles down to the member as well as most healthcare providers. Initially, upon becoming active, a new member is issued an insurance card. The informatics department receives a file from the state during the last week of each month to process. Upon completing the date entry, the updated list is sent to the eligibility department to review and finalize. Once this process is complete, customer service would mail the new insurance cards to each new member. The members use this insurance card as proof of coverage and to receive healthcare services. Historically, members would receive their insurance card in the mail within 7-10 business days. For obvious reasons, the delay in the insurance card delivery method was less than ideal. As a matter of fact, the time frame would delay visits with providers, scheduled procedures, interruption in the release of medical supplies and/or medications. In some instances, the member would never receive their insurance card. This mostly was due to old addresses or invalid information. Ultimately, a percentage of members would never receive the mailing or even become aware of it. Also, the organization was utilizing resources to complete the initial mailings and then sort through any returns. The returned mail required many hours of manual labor to identify which members needed to be flagged for missing or wrong address. The organization went through many efforts to search different databases and progress notes in hopes of locating a different address than the one originally used. As a result, the transformation process was enhanced and aligned to meet the member needs and organizational goals. Part of the enhancement included digital access to view their insurance card information. The insurance card information is available through a secure online portal on the company’s website (Community Health Group, 2020). This transformation process made it simple and easy for members to have access with little to no delays in care. In addition, the mailings and returns became minimal, and wasted resources have been reduced. This process has been especially beneficial during this pandemic. A physical insurance card is no longer the only option for a member to present to the healthcare providers. The digital card can be downloaded and saved in most devices making this convenient for all.

Community Health Group. (2020). Member Access. Retrieved from: https://www.chgsd.com/members/my-access

2. What is the difference between a “products or goods” versus “services”? What are some of the similarities and differences between the two? Can services be inventoried? (Last Question is Lecture Based) Give some examples based upon your experience as a customer or from your professional experience.

 

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