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Life & Specialty Ventures

Independently owned and geographically dispersed Blue Cross Blue Shield healthcare providers.

Life & Specialty Ventures was formed in 2005 to develop specialized insurance products (ancillary, life, disability, and dental) for several partner Blue Plans to add to the product portfolio. When a new dental venture became part of the Blues’ strategic business plan, LSV tapped the expertise of Rich Mankavech at Blue Cross Blue Shield Massachusetts, where he had worked for nearly 20 years rolling out large-scale projects and programs.

The goal: a new market

LSV needed to bring The Power of Partnering to Blue Cross Blue Shield plan owners and partners, businesses and their employees, and individual customers.

As Manager of Dental Network Cloud Administration & Operations, Rich had a new assignment: help LSV create value and capture market share in the dental market by delivering unique administrative value and delivering it less expensively. The challenge: do it in under six months.

The goal was to decrease the costs and time it took to contact, credential, and execute contracts with dental providers located in four states.

There were three key criteria that were crucial to the project's success. One, they needed to automate all related processes as much as possible. Two, they wanted to make the data accessible to all LSV sites and Blue plans (which required building something outside their existing environment). Finally, they needed to move the geographically dispersed workforce away from paper and faxes onto mobile devices. 

Or, as Rich puts it, speed to market, remote access, and true mobility. 

The challenges: scale and complexity

They had to take people out of their comfort zone of existing systems and processes.

“This was an implementation process with lots of moving parts: providers, members, Blue plans, claims, payments, sales, and marketing,” said Rich. “And different geographies had different process requirements—for example, some states were still requiring ‘wet’ signatures. We asked ourselves, can we even deliver a solution that will embrace and support all of these disparate functions?”

The answer was “yes,” but first they had to get over a number of significant challenges. 

The first challenge: none of the LSV/Blue sites could deliver a multistate solution in the required time frame because their priority was to maintain aging on-premise systems.

The second challenge was that the scale and complexity of the project was daunting. The project included: collecting and managing documents for 12,000 dental providers across multiple states and specialities, adding more than 100 new providers a month, maintaining and updating provider data on a consistent basis to support critical business functions, and implementing a complex integration of systems, people, and process. 

“We were taking people out of their comfort zone of existing systems and processes, which were different for each Blue plan.”

The solution: integrated cloud applications

The only way LSV could meet the criteria and timeframe was by utilizing cloud solutions for content management and provider relationship management.

LSV reached out to two highly regarded cloud vendors: SpringCM and salesforce.com. Their intention was to “move to the middle” with a centralized solution that would be accessible to all LSV sites supporting local Blue organizations. The result is a custom Salesforce cloud solution for managing the sales process integrated natively with SpringCM for managing content-intensive processes.

Phase one initially put 6,000 dental providers’ demographic data in Florida and Hawaii into the system and added approximately 100 new providers every month. Phase two and three added a number of other capabilities, ranging from data cleansing and credentialing status tracking to a paperless cloud with eSignature, eContracting, and eCommunications.

“The integrated solution is seamless to our users—which is perfect for us. When people ask us, ‘How the heck did you do this so fast?’ we tell them, ‘That’s our secret...and it’s an in-the-cloud model.’”
-Rich Mankavech

The results: a competitive advantage

Lower costs and greater efficiencies create a competitive advantage for LSV.

The integration of SpringCM and Salesforce was a winning solution for LSV. SpringCM was able to provide a centralized repository for documents, which created greater efficiency and reduced the time to settle issues raised by the medical committee from 40 days to less than 25 days. The solution created a standardized process resulting in fewer errors with minimal upfront investment and economies of scale that keep costs very low. 

In addition, SpringCM was able to provide automated workflows from document generation through approval and signature including generation of complex agreements using business rules. SpringCM also provided the mobile capabilities to give reps on the road easy access to contracts and collateral, all with the enterprise-class security and user access controls to keep content secure and to ensure compliance.  

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