Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
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Assignment 2
Analysis of Business Processes
Aim:
The aim of the 2nd assignment is to get familiar with the analysis of business processes.
Objectives:
O1. Increase your awareness for the challenges related to business process redesign.
O2. Apply the principles of business process redesign.
O3. Use process redesign approaches to fix issues in business processes.
O4. Demonstrate knowledge of process redesign approaches.
O5. Complete redesign tasks independently and within groups.
O6. Appreciate the social and organisational impacts of Process Redesign projects and effectively.
O7. Communicate your findings to stakeholders.
O8. Work effectively in team leadership roles in team projects.
1 Key Information
Group size: at most 4 students
Deadline: 27 October 2023, 23:59 (AEST)
Suggested page limit: at most 25 pages (excluding Title page, abstract, table of content, references &
appendices)
Weight: 30%
Submission: One PDF file + .bpmn (redesigned process) file per group on Blackboard
Questions: contact the teaching team during the tutorials, support sessions or via email:
• Dr Rehan Syed ( r.syed@qut.edu.au)
• Rob McMullen (r2.mcmullen@qut.edu.au)
2 The Assignment
Working in groups of at most four (4) students, you are asked to redesign the Health Insurance Claims Handl
ing process of 360-Degree Insurance as described in Section 3 and verify if the redesign will be beneficial.
You should deploy the following techniques:
1. Heuristics Process Redesign
2. BPR principles
3. Queueing theory
4. Simulation
Moreover, you need to consolidate the change option in a PICK chart along the dimensions of impact and
cost.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
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You need to produce a short report (not exceeding at most 25 pages (including everything) pages including
all figures), which includes the above items. An example report structure is shown in Section 4. See the
Marking Criteria in Section 5 for how we'll grade your assignment.
2.1 Handing-in
Please first register your group on Blackboard, and then submit the report as one PDF on Blackboard. Put
the names and student numbers of all students on the first page.
DECLARATION
By submitting this assignment, I am/We are aware of the University rule that a student must not act in a
manner which constitutes academic dishonesty as stated and explained in the QUT Manual of Policies and
Procedures. I/We confirm that this work represents my individual/our team’s effort, I/we have viewed the
final version and does not contain plagiarised material.
# Full Name Student No. Contribution Signature
1
2
3
4
2.2 Other things...
For anything else regarding the unit and assignments, please refer to the study guide on Blackboard. In
addition to the rules stated in the study guide, please observe the following:
• This is a 100% group assignment, and you are expected to work as a cohesive team.
• Some teams may have had non-contributing members.
• Close to the deadline, other students had to take over their work, on top of their own contribution
to not sacrifice their grade. Do not put yourself into such a position and start (& finish) the
assignment well before the deadline.
• The teaching team will only assist you up to one week before the deadline. Thanks.
3 Scenario
3.1 Health Insurance Claims Handling at 360-Degree Insurance
The insurance company 360-Degree Insurance as result of the process analysis that you conducted is now
aware of several issues affecting their core business process. In particular, they acknowledge that their
process is extremely inefficient and slow. To begin with, they are executing a lot of activities that are not
beneficial for the company, and that on the other hand, are only introducing extra costs.
In addition, during the handling of a claim, a lot of waste is produced due to handover of work between
employees (which causes the average time of the following activity to be 20% greater than needed), delays
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School of Information Systems
IAB320 Business ProcessImprovement
Page 3 of 9
caused by unresponsive customers and health providers, and excessive processing of claims which often
leads to rejections. Finally, they also realised that their senior claim handlers are over-utilised and result in
being bottlenecks for the entire process.
Due to all these issues, the company lost almost 70% of its customers. To prevent further losses, 360-Degree
Insurance decided to start a redesign initiative and placed you in charge of it. The following section
describes (same as assignment 1) the current insurance claims handling process at 360-Degree Insurance.
The process starts when a customer lodges a claim. To do so, the customer fills in a form including a 2-page
questionnaire describing the issue. The customer can submit the form physically at one of the branches of
360-Degree Insurance, by postal mail, fax or simply via e-mail (digitally signed document).
When a claim is received, a junior claims officer first reviews the claimants claims history to ensure a
duplicate claim has not been lodged. Next, the junior claims officer enters the claim details into the
insurance information system. Data entry usually takes 25 minutes. The same junior claims officer performs
a basic check to ensure that the customer’s insurance policy is valid and that the type of claim is covered by
the insurance policy. This operation takes on average 30 minutes. It is rare for the claim to be rejected at
this stage (it only happens in 7% of cases), in case of a rejected claim the customer is notified about the
rejection (operation that takes 15 minutes). Otherwise, the claim is marked as “eligible” and moves forward
in the process. Next, the claim is moved to a senior claims officer who performs an in-depth assessment of
the reported issue and estimates the monthly benefit entitlement (i.e., how much monthly compensation is
the claimant entitled to, and for what period of time). This operation takes on average 2 hour.
In the case of short-term benefits, the senior claims officer can perform the benefit assessment without
requiring further documentation. In these cases, the assessment is straightforward (despite tedious) and
takes 45 minutes. As part of the benefit assessment, the senior claims officer also checks if the claim is
associated with an issue for which there is already an ongoing payment. A positive result to this check
results in a desk reject (which occurs in 4% of the cases). Once a decision is made, the senior claims officer
registers the entitlement on the insurance information system and informs the customer of the outcome via
e-mail or postal mail.
However, in the case of long-term claims (more than three months), the senior claims officer requires a full
medical report in order to assess the benefit entitlements. Senior claims officers perceive that these medical
reports are essential in order to assess the claims accurately and to avoid fraud (which only occurs in 3% of
the cases). Once the senior claims officer has received the medical report, they can assess the benefits in
about one hour on average. The senior claims officer then sends a response letter to the customer (by email and post) to notify the customer of their monthly entitlement and the conditions of this entitlement
(e.g., when will the entitlement be stopped or when is it due for renewal). The entitlement is recorded in
the insurance Information System.
Later, a finance admin triggers the first entitlement payment manually and schedules the monthly
entitlement for subsequent months. The finance admin takes on average 30 minutes to handle an
entitlement. Finance admin handle payments in batches, once per working day.
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IAB320 Business ProcessImprovement
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When a medical report is required, a junior claims officer contacts the customer (by phone or e- mail) to
notify them that their claim is being assessed, and to ask the customer to send a signed form authorizing
360-Degree Insurance to request medical reports from their health provider (hospital or clinic). Health
providers will not issue a medical report to an insurance company unless the customer has signed such an
authorization. In general, the authorization is received within 5 days from its request (requesting it only
takes 05 mins), despite in 2% of the cases the customer does not provide the authorization and after a
waiting period of 14 days the claim is withdrawn.
Once the authorization has been received, the junior claims officer sends (by post) a request for medical
reports to the health provider together with the insurer’s letter of authorization, requesting the medical
report takes on average 25 minutes. Hospitals reply to 360-Degree Insurance either by post or in some
cases via e-mail. On average, it takes about 14 working days for 360-Degree Insurance to obtain the medical
reports from the health provider (including 3 working days required for the back-and-forth postal mail). This
average however hides a lot of variance. Some health providers are very cooperative and respond within a
couple of working days of receiving the request. Others however can take up to 30 working days to respond.
As a result, the average time between a claim being lodged and a decision being made may take several
days. Naturally, so long waiting times cause anxiety to customers. In the case of long-term claims, a
customer would on average call or send an e-mail enquiry twice, while the claim is being processed. Such
enquiries are answered by the junior claims officer, and it takes about 10 minutes per enquiry. In about a
third of cases, junior claims officers end up contacting the health provider to enquire about the estimated
date to obtain a medical report. Each of these enquiries to health providers takes 10 minutes to a junior
claims officer.
The total benefit paid by the insurance company for a short-term issue is AUD$ 5K (typically spread across 2
or 3 months). For long-term issue, this amount is 30K, but some claims can cost up to 45K to the insurance
company. In case of long-term issue, the duration of the benefit (number of months) cannot be determined
in advance when the claim is lodged. In these cases, the benefit is granted for a period of 3 months and the
entire process is repeated (a new claim needs to be submitted) to determine if the benefit should be
extended. It often happens that the renewal takes too long, and customers stop receiving their monthly
benefit temporarily during the renewal process.
The insurance company receives 2855 claims per year (including resubmitted claims), out of which 25% are
for short-term issue and 75% for long-term issue.
The company employs three full-time junior claims officers, two full-time senior claims officers, and one fulltime financial officer. Their salaries are respectively $65,000 pa, $80,000 pa, and $95,000 pa. The
employment contact requires a full-time employee to works 8 hours a day (including 45 minutes unpaid
lunch break).
Finally, Figure 1 contains model of their “Health Insurance Claims Handling” process.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
Figure 1: The health insurance claim process of 360-Degree Insurance.
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
4 Example report structure (your report MUST include the following
sections)
• Cover page
• Executive summary
• Table of contents
1. Process redesign
Present the results of the redesign: for each change applied, justify the change via the redesign
heuristics or the BPR principles.
2. Queueing Theory
Compare queue length of the current AS-IS process with the expected queue length of the TOBE process assuming zero delays. Limit your analysis to a single server (M/M/1)
3. Simulation
Compare the performance of the AS-IS process with the expected performance of the TO-BE
process and highlight the points of improvement.
4. Change Option Consolidation
Consolidate all the issues in a PICK (Possible, Implement, Challenge, Kill) chart.
5. Conclusion
Based on the above results, provide a well-structured summary on how to solve the issues
affecting the business process in the scenario.
6. References (APA Style)
7. Appendices
Please include all calculations in this section
Please ensure that your .bpmn file is attached
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
5 Report Formatting Requirements
5.1 Guidelines for using Headings.
Please use the number headings format (see example)
1.0
2.0
…
Level 1
1.1
1.2
….
Level 2
1.1.1
1.2.1
…
Level 3
1.1.1.1
1.1.1.2
1.2.1.1
...
Level 4
5.2 Page margins.
25mm (top), 25mm (bottom), 25mm (left), 25mm (right)
o All tables and figures must be captioned. Sources (if applicable) must be provided.
5.3 Font
o Calibri or Times News Roman
5.4 Referencing
o Please use APA for all intext citations and referencing
o Additional information is available at the following link
https://www.citewrite.qut.edu.au/cite/qutcite.html#apa
Queensland University of Technology
School of Information Systems
IAB320 Business ProcessImprovement
1 Marking Criteria
This is a draft of the marking criteria we will use to mark the first assignment, to give an idea what we’re looking for. If multiple boxes could apply, we generally
choose the leftmost one. The points sum to 100 and count for 30% towards the unit score.
Criterion Weight 0%-24% 25%-49% >50% >65% >75% >85%
100 The Analysis achieves NONE of the
following
The Analysis achieves FEW ofthe following The Analysis achieves SOME of thefollowing in
a Satisfactory Way
The Analysis achieves SOME of
the following in an Appropriate
Way
The Analysis achieves MOST of the
following in an Effective Way
The Analysis achieves ALL of the
following in a Highly Effective Way
Format of report:
The report should be
presented in a professional
manner and without spelling
and grammar errors. All
tablesand figures must be
clear, well organised and
embeddedinto the flow of
the argument.
3 • Written expression and
presentation are incoherent,
withlittle or no structure, well
below the required standard
· Structure of the document isnot
appropriate and does not meet
expectations for a projectreport.
· Structure of the document needs some fine
tuning but is sufficient and meets some of the
expectationsfor a project report.
· Structure of the document is
appropriate and meets most
expectations for a projectreport.
· Structure of the document is
appropriate and meets
expectations for a projectreport.
· Structure of the document is
appropriate and meets expectations
for a project report well.
· Meaning unclear as grammar and/or spelling
contain frequenterrors.
· Meaning apparent, but languagenot always
fluent.
· Language mainly fluent, but some
minor areas that may lead to
confusion.
· Language fluent. · Clarity promoted by consistent use
of standard grammar, spelling and
punctuation. No errors.
· Disorganised or incoherentwriting. · Grammar and/or spelling containerrors. · Grammar and spelling mainlyaccurate. · Grammar and spelling accurate.Few
errors.
· Sentences skilfully constructed:
unified, coherent,forceful, varied.
· Required references are frequently
missing. The APAstyle is not appropriately
applied.
· Occasional inappropriate vocabulary,
style or tone forprofessional writing.
The tone and style of writing are
generally appropriate but may be
informal or conversational at times.
· Professional presentation. · Paragraph structure effectively
developed.
· Occasional unprofessional,untidy, or
unattractive presentation.
· Neat and tidy presentation. · Key statements are justified by
references as required. The APA
reference style is used with
minimal (at most one to two)
formatting errors.
· Fluent, professional style andtone
of writing.
· A reference list and in-textcitations are
included; somecitations/ related citation
information are missing.
· APA style is used for references and
in-text citations; some additional
supporting citations arerequired.
· Polished professional appearance.
· All key statements are justified by
references as required. APA reference
style is used without any formatting
errors.
Executive summary: The
executive summary has to
provide a stimulating
introduction. It should
include the key findings and
be at the right abstraction
level, i.e. not be just on a
metalevel (“This report will
discuss. . . ”).
4 · No Executive Summary written. · Executive Summary written but none of the
essential aspectscaptured.
· Writes an Executive Summary without
capturing all the essentialaspects of the
project or outcomes.
· Executive summary clearly captures
all the essential aspects ofthe project
and its outcomes.
· Executive Summary is
systematically, comprehensively
and succinctly presented.
Demonstrates independent
thinking.
· Executive Summary is
systematically, comprehensively
and succinctly presented.
· Demonstrates independent and
insightful thinking.
Introduction: The
introduction should
contextualise the company,
illustrate the purpose of the
report in a well-structured
manner. It should conclude
bypresenting the structure
of the report.
4 · Little or no clear: introduction,
topic, audience or relevant context.
Very hard to read and comprehend
Project goals and promised
deliverables are not articulated at
all. Poor contextualisation, where
prior work is not integrated at all to
support study motivation.
· General, unclear introduction. · Introduction gives some indication of the
scope of the work but requires further
development. Project goals and promised
deliverables are vaguely articulatedwith little
link to the overall context.
· Introduction provides general
indication of the scope of the work.
Goals and promised deliverables are
articulated but not made very clear
and are weakly linked to the context
provided.
· Introduction outlines purpose,
objective and scope of the work.
Goals and promised deliverables are
articulated in a manner that can be
understood by a broader
readership.
· Introduction clearly expresses the
purpose, objectives and scope of the
work. Goals and promised deliverables
are clearly articulated in a manner that
can be understood by a broader
readership.
· Articulation of goals and
promised deliverables are
· Discussion generally aimed at the
topic, however grasp of the topic
· Discussion is focused on the topic
however some key issues may be
· Discussion is well focused on
the topic and majority of key
· Key issues are identified and
clearly defined. Study motivation
attempted but are unclear and incomplete
and not linked to the overall context.
may be inadequate. Study motivation is not well
supported, with limited literature and limited
conceptual arguments.
missing or under-represented. Study
motivation is supported with some
literature and some conceptual
arguments
issues are identified. Study motivation is
supported with literature and conceptual
arguments
well-grounded with supporting
literature and conceptual arguments.
· Lacks evidence of knowledge or
understanding relevant to topic. Literature
(or conceptual arguments) are not
integrated to support the study motivations
· Central ideas are very generalised, without any
clear focus and may be confused and/or
unsupported.
· Central ideas are apparent but may be
generalized or too trivial.
· Central ideas are apparent. · Ideas are developed in clear, concise
and ordered stages.
· No consideration of the audience.
· Context not recognized as relevant.
· Unsatisfactory awareness of the audience. · Acknowledges the audience, but may
only partially meet their needs.
· Generally acknowledges and meets the
needs of the audience
· Well focused with the appropriate
audience in mind. Clearly identifies
relevant contexts.
Queensland University of Technology
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IAB320 Business ProcessImprovement
Conclusion: The conclusion
should summarise the main
findings, contextualise the
report and cover any
potentiallimitations. In a
limited fashion, the
conclusion should outline
potential next steps that
could be performedusing
this report.
4 · Few or no conclusions or
recommendations.
· Conclusions are unclear, not well supported
or connected to aims
· Attempts to provide conclusions however they
may need further development and/or may not
be appropriate and/or may not be linked to the
original aims of the project.
· Mechanical conclusions drawn from
the theory and literature: clear, linked to
the original aims, but may be general.
· Logical conclusions, grounded in the
theory and literature, considering new
ideas or concepts and linked to the
original aims of the project.
· Analytical and clear conclusions wellgrounded in theory and literature,
showing the development of new ideas
and concepts and linked to the original
aims of the project.
· Few recommendations, without clear
evidence or argument
· Limited attempt to make recommendations. · Recommendations made are generally
sound and valid, but lack originality.
· Valid and original recommendations are
presented.
· Valid and original recommendations
are presented with confidence.
PROCESS REDESIGN.
Process redesign:
a list of change options
should be provided. For
eachchange option applied
to the AS-IS process
model, you need to justify
the change viathe redesign
heuristics or theBPR
principles.
40 • No redesigned processes
were presented. No discussion
on BPMPrinciples.
· Limited or no clear redesign. · Satisfactory re-design approach. · Appropriate re-design approach. · Good re-design approach. · Excellent redesign approach.
· Limited or no description oftechniques used · Adequate description oftechniques used · Appropriate description of
techniques used supported by
relevant references
· Good details and description of
techniques used supported by relevant
references
· Excellent details and descriptionof
techniques used supported by a
verity of relevant references
· No/Very Limited explanation/application
of redesign-heuristics AND/ORBPR
Principles
· Limited explanation/applicationof redesignheuristics AND/OR BPR Principles
· Adequate
explanation/application of redesign heuristics AND/OR BPR
Principles
· Good explanation/application of redesign heuristics AND/OR BPR
Principles
· Clear explanation/application of
redesign- heuristics AND/OR BPR
Principles
· Many modelling errors · Few errors design errors · Results with few errors · Results with few minor errors · Results with no/very minor errors
· Limited or no justifications · Limited justifications · Appropriate justifications · Good justifications · Excellent justifications
QUEUEING THEORY
Queueing theory:
the expected queue length
of the current AS-IS
process should be
compared with the
expected queue length of
the TO-BE process
assuming zerodelays.
10 · No Analysis presented · Incomplete analysis · Satisfactory analysis. · Appropriate analysis. · Detailed analysis. · Excellent analysis.
· Many errors · Results with few errors · Results with few errors · Results with minor errors · Clearly explained steps
· Limited or no comparison · Limited comparisons withreasonable
elaboration and explanation
· Adequate comparisons with
reasonable elaboration and explanation
· Good comparisons with
reasonable elaboration and
explanation
· Excellent comparisons withreasonable
elaboration and explanation
PROCESS SIMULATION
1. The results obtained
from process simulation
over the AS-IS process
model shouldbe covered.
5 · No Simulation presented · Incomplete analysis · Satisfactory analysis · Appropriate analysis · Good analysis · Excellent analysis
· Many errors · Few errors · Few errors · Minor errors · Very minor/No errors
· Limited or no elaboration ofresults · Limited elaboration of results · Adequate elaboration of results · Good elaboration of results · Detailed elaboration of results
2. Simulation over the TO-BE
process model should be
covered.
5 · No Simulation presented · Incomplete analysis · Satisfactory analysis · Appropriate analysis · Good analysis · Excellent analysis
· Many errors · Few errors · Few errors · Minor errors · Very minor/No errors
· Limited or no elaboration of results · Limited elaboration of results · Adequate elaboration of results · Good elaboration of results · Detailed elaboration of results
3. A critical analysis of the
improvements obtained by
the TO-BE process model over
the AS-IS process model
should be described
20 · No Analysis presented · Incomplete analysis · Satisfactory critical analysis · Adequate critical analysis · Good critical analysis · Excellent critical analysis
· Mostly irrelevant · Mostly relevant · Relevant discussion on process
improvements
· Relevant discussion on process
improvements
· Incisive discussion on process
improvements
· Limited/No comparison of AS- IS and TO-BE
models
· Limited comparison of AS-IS and TO-BE models · Appropriate comparison of AS-IS and
TO-BE models
· Detailed comparison of AS-IS and
TO-BE models
· An excellent comparison of AS-IS and
TO-BE models
PICK CHART
The results of the redesign
should be summarised and
allthe proposed change
options should be presented
through the use of a PICK
chart.
5 · No Analysis presented · Incomplete analysis · Satisfactory analysis · Appropriate analysis · Good analysis · Excellent analysis
· Mostly irrelevant · Mostly relevant and supportedwith evidence · Most points were relevant and
supported with evidence
· Most points were relevant and
supported with evidence
· All points were relevant and
extensively supported with
evidence
· Limited/No change optionsdiscussed · Limited change options discussed · Appropriate change optionsdiscussed · Key change options discussed · All change options discussed