Business Process Management
An Overview of Practice at
Blue Cross and Blue Shield of Nebraska
Process Management Process Management
Process Design
Process Design
Pro
cess
Impr
ovem
ent
Pro
cess
Impr
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Presentedby:
Bob Tippett, Director of Business Process Engineering
Rich Rozgay, Director of Six Sigma
Process Management Process Management
Process Design
Process Design
Pro
cess
Impr
ovem
ent
Pro
cess
Impr
ovem
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Agenda BPM, BPE and Lean Six Sigma Implementation Strategies BPE at BCBSNE Lean Six Sigma at BCBSNE Synergies of BPE and Lean Six Sigma Lessons Learned Open Discussion / Q&A
BPM at BCBSNE• Methods
– Business Process Engineering– Lean / Six Sigma– Value Chain Analysis
• Tools– Microsoft Office Suite (Documentation, Analytics and
Toolkits)– Microsoft Share Point (Collaboration) – Enterprise Architecture Sparx (Process Modeling w/ BPMN)
• Technologies– Service Oriented Architecture (SOA)– Off - the - Shelf– Business Process Management Suite (BPMS)
Implementation Strategies• Lots of Options – You Need to Understand:
– Culture – ready for change?– Organizational Risk Appetite – mistakes are opportunities to learn– IT Environment – resources and systems accessible to projects – Available Professional Expertise – lots of new skills and knowledge– Available Tools and Methods – integration and ownership
• Executive Driven PI - Top Down– Broad in Scope (Corporate)– Long timeline and big $$$ commitment (3-5 years, millions of $)– Broad organizational impact
• Mid-Level Management Driven PI– Narrower Scope (Divisional / Departmental)– More flexibility to manage outcomes, easier to gain agreement for action– Constrained organizational impact
• Grass Roots PI – Bottom Up– Tightly Focused Scope (Department / Workgroup)– Full control of goals and objectives, resources and outcomes– Narrow organizational impact
What is BPM?Business Process Management (BPM) is a set of methods, tools and technologies used to design, enact, analyze and control operational business processes.
- SoftwareAG
What is Lean Six Sigma (6σ)?Lean Six Sigma for services is a business improvement methodology that maximizes shareholder value by achieving the fastest rate of improvement in customer satisfaction, cost, quality, process speed, and invested capital.
- California State University
What is BPE?The analysis and re-design of business processes and associated technology systems, with the goal to eliminate or reduce redundancy and streamline interactions.
- Deputy Undersecretary of the Army
The “Super System” - Rummler
Copyright © 2006. Performance Design Lab. All Rights Reserved.
Business Process Engineering• American Productivity and Quality
Council (APQC) Process Classification FrameworkSM (PCF) provides an industry-neutral framework•The first version of the BCBSNE EBPM. All EBPM reflected the generic nature of the APQC PCF.
Copyright © 1994-2009 All Rights Reserved.
BCBSNE Enterprise Process Model
EBPM Process Categories• Core Processes
– Processes that are essential to creating value for customers
– All customer-facing processes – Processes which develop, sell and deliver
products/services to the company’s markets– Litmus test: “Did the company go into business to do
this?”– Differentiation in these processes is the key to creating
(and potentially sustaining) competitive advantage for the company
• Governing Processes– Provide guidance and direction to other processes
• Enabling Processes– Create key capabilities for core processes
• Supporting Processes– Provide resources and services to other processes– Provide no direct inputs to customers– These processes are performed by every company in
every industry– Primary objective for these processes is effectiveness and
efficiency
2.0Develop Health and Wellness
Solutions
2.0 Develop Health and Wellness Solutions• Formerly “Design and Develop Products
and Services”• This category contains processes
related to designing, developing, implementing and managing health and wellness solutions that the company provides to the market. It begins with the idea for a health and wellness solution and ends with the implementation of a marketable health and wellness solution. It includes the following:
– Researching and conceiving new health and wellness solutions
– Designing health and wellness solutions, including pricing
– Obtaining regulatory approval for health and wellness solutions
– Introducing health and wellness solutions into the company’s target markets
– Implementing health and wellness solutions into business operations, including establishing the capability to sell and administer the solutions through the company’s processes and systems
– Conducting ongoing management of the company’s portfolio of health and wellness solutions
3.0 Market and Sell Health and Wellness Solutions
• Formerly “Market and Sell Products and Services”
• This category contains processes related to bringing the company’s health and wellness solutions to the markets it serves through all distribution channels. It deals with activities from initial contact with a potential prospect through the point of sale. It includes the following:
– Developing and managing sales strategy
– Managing sales opportunities and pipeline, including handling requests for proposal
– Developing and executing advertising campaigns
– Establishing and maintaining relationships with distribution channels (e.g. brokers)
– Managing new and renewal sales through all distribution channels
3.0Market and Sell
Health and Wellness Solutions
4.0 Fulfill Health and Wellness Solutions• Formerly “Deliver Products and
Services”• This category contains
processes related to carrying out the sale of the company’s health and wellness solutions. It deals with activities from the point of sale through fulfillment. It establishes prospective groups and members as customers. It includes the following:
– Handling new and renewal business applications
– Analyzing risk (including medical review) and the communication of risk analysis results
– Managing group and member enrollment
– Administering physical fulfillment (e.g. generation and delivery of insurance policies, ID cards)
4.0Fulfill Health and
Wellness Solutions
5.0 Service the Customer• This category contains
processes related to providing service to the company’s customers (directly or indirectly) and those acting on behalf of customers (e.g. providers, brokers, employee benefit plan administrators, and partners). It includes the following:
– Managing the customer relationship
– Responding to all service requests (e.g. inquiries, problems) related to the ongoing service of health and wellness solutions
– Proactively providing service
– Providing first- and second-level customer support
– Administration of claims
5.0Service the Customer
Process Hierarchy at BCBSNE
Level 1 - Enterprise Processes (12)
Level 2 - Process Group (50+)
Level 3 - Business Process (250+)
Level 4 - Sub Process (1000+)
Steps/Procedures (10000+)
Increasing Detail,Narrowing Scope
Decreasing Detail,Broadening Scope
BCBSNE EBPM Level 1BPMN Enterprise Business Process Model
«Group»Enabling Processes
«Group»Supporting Processes
«Group»Core Processes (Value Chain)
«Group»Governing Processes
«Pool»
BlueC
ross BlueShield of N
ebraska
Develop Health andWellness Solutions
Market Health andWellness Solutions
Administer HumanResources and
Services
Set Strategic andOperational Direction
Fulfill Health andWellness Solutions
Service the Customer
AdministerInformationTechnology
Resources andServices
Administer FinancialResources and
Services
Administer CorporateRelations
Administer BusinessPerformance
Administer ProviderNetworks
Administer PhysicalResources and
Services
MarketableHealth andWellnessSolutions
Agreementto Purchase
Direction
Direction
EstablishedMembers andGroups
Feedback
Feedback
BCBSNE EBPM Level 2BPMN Service the Customer
«P
ool»
BCB
SN
E
«Lane»
VP
, Pharm
acy
«Lane»
SV
P, C
laim
s«
Lane»
VP
, Mem
ber S
erv
ices
Start Service the Customer
Develop CustomerRelationship
Management Strategy
Administer ServiceRequests
End Service the Customer
Administer Claims
Plan and ManageCare
Administer Pharmacy
BCBSNE EBPM Level 3BPMN Plan and Manage Care
«Pool»
BCB
SN
E
«Lane»
Start Plan & Manage Care
Develop & MaintainMedical Policies
Develop MedicalManagement Strategy
End Plan &Manage Care
Provide MedicalReview
Manage Claims,Authorizations, &
Precerts
Manage Appeals &Grievances
Perform CaseManagement
Manage DiseasePrograms
Manage WellnessPrograms
Provide OutreachPrograms
Evaluate Outcome &Report Performance
BCBSNE EBPM Level 4BPMN Manage Authorizations & Precerts
«P
ool»
BCB
SN
E
«Lane»
Health
Serv
ice P
rogra
ms (
HSP)
«Lane»
Medic
al S
upport D
epartm
ent (
MSD
)
Records
LOI Letter Sent byCoreLink to Member
/ Provider
Prior Approvals
PreAuths
Phone
- E-mail- FaxMaker- Letter- Thor- WiseGUI
Start Manage Authorizations and Precerts
Receive Request /Claim
Route
Make Decision(CCMS)
Pend for More Info(CCMS)
Update System(CCMS)
Send AppropriateLetter to Member,
Provider, &Institution (CCMS)
Receive Info
Internal or ExternalPhysician Review
Route toApppropriate Nurse
(CCMS)
Close Out Event(CCMS)
End Manage Preauthorizations & Prior Approvals
Claim
Receive Claim fromMacess
Forward to CSC
End Manage Authorizations & Prior Approvals
Make & DocumentDecision (CCMS)
Make & DocumentDecision (CCMS)
Internal or ExternalPhysician Review
Receive Info (CCMS) Pend For More Info(CCMS)
Update System(CCMS)
Denial
Make & DocumentDecision (CCMS)
Send AppropriateLetter to Member,
Provider, &Institution (CCMS)
Close Out Event on(CCMS)
End Manage Preauthorizations & Prior Approvals
Creates Case File(CCMS)
Create Case Note(CCMS)
Case Notes & Claim
Nurse ReviewerReviews Decision
Reviewed Docs
Is this a Med Necessity Denial?
Nurse Composes MedNecessity Denial
Letter on CoreLinkLetter GUI
Send Letter viaCoreLink Letter GUI
Nurse DocumentsDecision on CoreLink
Notes ScreenEnd Manage Claims
Claim Pended not toExceed 47 / 50 Days
Rationale Received Within 47 / 50 Days?
Rationale is Acceptedon Letter GUI by
Pending Clerk (MRU)
Is This a Medical Necessity Review?
CoreLink SystemAuto Denies for NoAnswer to Inquiry
Generate Report
End Manage ClaimsLetter
End Manage Claims
Records Reffered toIIC
Records
Records Receivedfrom IIC
Nurse Notified ofRationale Update
(Macess)
Payment
PaymentDenial
Requested Info Info Request
Requested Info Info Request
Review Claim and AllAvailable Information
1st or 2nd Level Review?
Document on NotePortion of CoreLink
Claims / MacessEnd Manage Claims
Days
Rationale is Requestedfrom Provider/Plan
Days
Attach by MTM orDOL with OriginalClaim & Inserts
Look in BlueBridge(Coverage Inquiry)
Advise Non-Member
Eligible for Service?
End Manage Authorizations &Precerts
Review History &Criteria
Review Documents
SearchDocumentation
Search Medical PolicyManual
Review History(Macess, CCMS,
Track)
Review Documents
Store Letter Image inMacess
- CoreLink Blue2 - Letter is being sent via CoreLink Letter GUI
- Nurse Reviewer Creates Case Note on CCMS and Refers to Physician via CCMS
Store Letter Image inMacess
Return Claim toAuditor (Via Macess)
Claim
Look for Eligibility Claim / Retro Review or Prior Approval / Preauthorization?
Send to MSD
Claim
End
Create Event (CCMS)
Search in BlueBridge (Benefit Matrix), Documentation Search,& Procedure & Diagnosis Code Lookup (Eagle).
Approval
Forward via FaxMaker or WiseGUI
Review Request
Store Letter Image inMacess
MSD or MPR?Send to MPR
Claim
Create Note
Search in BlueBridge (Benefit Matrix), Documentation Search, & Procedure & Diagnosis Code Lookup (Eagle).
Attach to claim in CoreLink system(s).
Note contains logic for auditors to make decisions.
Letter
The CoreLink system does this automitically
Reminders are send out at 15 and 47 days
Existing Review?
Status of claim changes from pending / investigative status to openat which point the claim is pulled into the Macess docflow.
Records received after close date?
Update CoreLinkBlue2
Home claim only
Reinventory Claim
Claim is resent to Macess at this point
Report generated by Med Necess RNA
Nurse reviewer creates case file on CCMS / Note on Claim (CoreLink)
Need ActiveX script for this step
Needs to be built
«Lane»
Medic
al P
re-R
evie
w (
MP
R)
Receive Claim fromMacess
Update Claim Send to MedicalReview
Claim
Claim Pended not toExceed 47 / 50 Days
Review Claim and AllAvailable Information
Pay/Deny, Pend, or Med Review?
Document on NotePortion of CoreLink
Claims / MacessEnd Manage Claims
Days
Rationale is Requestedfrom Provider/Plan
Days
Attach by MTM orDOL with OriginalClaim & Inserts
- CoreLink Blue2 - Letter is being sent via CoreLink Letter GUI
Create Note
Search in BlueBridge (Benefit Matrix), Documentation Search, & Procedure & Diagnosis Code Lookup (Eagle).
Attach to claim in CoreLink system(s).
Note contains logic for auditors to make decisions.
Letter
The CoreLink system does this automitically
Reminders are send out at 15 and 47 days
Existing Review?
Need ActiveX script for this step
- Use work in progress queue with attachments.- Use round robin assignment (Fair Square / Balanced Workload) and direct assignment to an individual.
MBS, Macess, Eagle, InterQual, Value Option
Use Reminderfor managingopen events.
If response is received after 48hrs., the event isreopened
Info Received in 48 hrs.?
Close Event (CCMS)
End Manage Authorizations & Precerts
- Address supression check- Dependent age check
Route using Reminder
Routed to 1st level reviewer via WIP
Forward toAppropriateDepartment(WiseGUI)
- Update notes in MBS prior to batch cycle. Notes are locked after batch cycle.
- This information is also updated in the claims system (Eagle)
Response Received in 50 Days?
Send LOI Letter &Close Event (CCMS)
End Manage Authorizations & Precerts
LOI Letter
- Address supression check- Dependent age check
Call Provider and / orMember
Phone Update
- Update notes in MBS prior to batch cycle. Notes are locked after batch cycle.
- This information is also updated in the claims system (Eagle)
Route using ReminderRouted to 1st level reviewer via WIP
Prior Approval(FormerlyPreAuth)
No
1st Level
Yes
No
2nd Level
Pay
Pend
CSC PriorApproval
2ndLevelReview
Pay
Pend
Misroutes
Pend
Yes
No
MedReview
Yes
Existing
MPR
Claim / RetroReview
MedicalPriorApproval
Prior Approval /Preauthorizations
MSD
Yes
Yes
No
No
Yes
No
PreAuth(FormerlyPrecert)
Pay / Deny
No
No
Yes
2ndLevelReview
Yes
No
Yes
The Organizational Status Quo
“The only things that evolve by themselves in an organization are disorder, friction, and mal-performance.”
- - Peter Drucker
Lean Six Sigma at BCBSNE• Where We Are With Lean 6σ• Where We Are Going• How We’ll Get There
Where Are We with Lean 6σ
Our processes are sometimes inconsistent and / or inefficient = too much manual work
Our organization is under stress Competition (lonely at the top) Resources Constraints Mandates and CoreLink Constraints
We all have the formal or informal responsibility to improve our processes
“Better, Faster, Cheaper, NOW!”
Where Are We Going? Half of getting where you are going is knowing where you are getting
Streamlined processes will improve our flexibility, lower resource requirements and improve morale
We work in a target-rich environment
How Are We Going to Get There? Six Sigma
Six Sigma reduces variation in processes Requires high level of expertise and reliable
data Very effective in certain situations
Lean Six Sigma Hybrid approach designed to provide the best
of both worlds Does it work? The debates rage on!
Problem Solving Process Quick way to solve a specific issue or problem
The Process Mindset
“If you can't describe what you are doing as a process, you don't know what you're
doing.” --W. Edwards Deming
Core of Engineering Process Example
Y
No/Maybe
A ApplicationComplete
Letter or Phone Call to Applicant
I
I
Recv. Add. Info
Public NoticeDrafted
Public Notice Issued
I I
Corp Review Comment Ltr
Ltr to Appl.
I I
Water Quality Certif
Endangered Species
Cultural/Tribal
EssentialFish Habitat
I
I
I
I
I
Assess ESA info.
Review Response
IncompleteI
Decision Document
I
Services ReviewEffect?
I
Contact Applicant
Complete?
II
Consultation and Draft BD
Appl and Corp Review draft
BO
Service Completes BO
I
Indvidual Permit Process
Coord w/ Arch/Corps,
Cultural Resources
Complete?
N
Sec 106 Determ
I
Effect? GenerateLtrs
IY Maybe
SHPO Rev Sec 106
Complete?
INN
SHPO DraftsMOA
Corps forwards
MOA to Tribes
Corps forwards
MOA to SHPO
SHPO signs MOA
MOA Complete
Coastal Zone Mgt.
N
Y
B
External Organization
Ledgend
B
I
Draft Decision Doc and
Permit Ltr. I
Sec ChiefReview
80%
Branch Chief/Distr Eng.Review
Put in Final Form
Permit Decision Issued
Applicants
I I
Indvidual Permit Process
Applicant Sign
Corps Sign
Value Statement
Timely issuance of a permit decision that
comply with Federal laws and regulations and, if a permit is issued, enables the applicant to proceed with a practicable project
Key Requirements
Domestic Statutory and Regulatory Requirements
Measurements
· Turn-a-round Time – i.e. elapsed time from date application is
received to permit issued Goal is 100% within 120 days
· Total Application Backlog - i.e. number of applications in process
and/or waiting to be processed at any given time. Goal is to reduce by 50%
· First Pass Yield of Applicant Submittals – Percent Complete and
accurate the first time. Goal is to increase FPY to <90%
Ideal State
· On-Demand· Defect Free· 1-By-1· Lowest Cost
Applicant
Sec Chief assigns to PM
PM Review for completeness
Complete? Yes
No
Csll/Email Applicant
for more info.
Receive Additional
Applicant Info
25%
75%
Site Visit Office Visit
Field Visit
Develop Disclaimer Letter
Verify Delineatio
n
Sec Chief Review
Office of Council Review
No permit or Jurisdiction Required
PM Issues Letter
Letter Developed
JDs
I
I
I
I
I
I
I
I
I
Set up Field Visit Verify
Letter Developed
More Info.
Field Visit
N
Y
I
PM SignsLetter
Applicant Appeals
I
1%I
Send Additional Info to District I
I
2nd
Applicant Appeal
Admin Records Prep
Division ReviewAppeal
Mtg.
Division Process Correct
YII
I
I
IICourt and/or
AppealI
Review Application
30%
A
Jurisdictional Determination
Business Case
In light of increasing workload and complexity
associated with the regulatory program, efficiency must be
increased to maintain the quality of permit decisions
Total Cycle Time = 152 - 383 days Total Touch Time = 105 - 132 Hrs
Total Cycle Time = 152 - 383 days Total Touch Time = 105 - 132 Hrs
Categories of Process Activities
Customer Value Add (VA) Any activity in a process that is
essential to deliver a service to the customer
Business Value Add (BVA) Activities that are required by the
business but add no real value from a customer standpoint
Non-Value Add (NVA) Everything else!
Typically the largest contributor to process cycle time is non-value add activities, while the smallest contributor is Customer Value
Add activities
Process Cycle Time Process Cycle Time (PCT) is the total
time to complete an activity or process.- e.g., complete application, load the
member & pay the claim
VAVA Business Business Value AddValue AddNon-Value Add Non-Value Add
1. Waste of Overproduction
2. Waste of Time (Idle)
3. Waste in Transportation
4. Waste of Processing
5. Waste of Inventory
6. Waste of Movement
7. Waste of Making Defective Products
8. Waste is the Waste of People – Ignoring their ideas!!!! 8th
Lean Eliminates Waste
How Do We Get There?
Be Mindful of Counter intuitive fixes!
We train people and ignore process
We improve VA steps when the problem is NVA
Value Stream Analysis (VSA) / Lean Deliverables
Current Process Map - Where are we now Future Process Map - Where are we going Action Plan to Achieve the Future - How are we going to get there Implementation Guidance
- Procedures which are the future rules drafted by those who will have to use them
Lean Mapping Basics Mapping is about the process, not the
software
Everything is serial for your process. If you think there is a parallel event occurring, think harder
Design for success. Then the point of failure will become obvious
Lean – Before and After Example
HQ PARC sends formal approval of plan
Revised final plan sent to PARC for Sig
PARC AO prepares approval memo
HQ reviews plan
HQ distributes plan for review
District submits revised plan
District resolves cmts
HQ sends cmts to MSC
HQ reviews plan
RIT distributes plan for review
HQ distributs plan for review
HQ logs In plan reciept
MSC/DoCreviews and sends to HQ
District sends revised draft to MSC
District resolves cmts
MSC sends cmts to District
MSC reviews draft
AcqPlan Distributed in MSC
Staff for Signature/Send to MSC
Resolve Cmtsand Finalize
Staff Draft within District
Resolve KO Cmts/Finalize Draft
Staff Plan to KO/PA
Draft Initial AcqPlan
Finalize AcqStrategy
Conduct Market Research
Determine that formal ACQ Plan is required
272625242322212019181716151413121110987654321
Current Process
HQ PARC sends formal approval of plan
Revised final plan sent to PARC for Sig
PARC AO prepares approval memo
HQ reviews plan
HQ distributes plan for review
District submits revised plan
District resolves cmts
HQ sends cmts to MSC
HQ reviews plan
RIT distributes plan for review
HQ distributs plan for review
HQ logs In plan reciept
MSC/DoCreviews and sends to HQ
District sends revised draft to MSC
District resolves cmts
MSC sends cmts to District
MSC reviews draft
AcqPlan Distributed in MSC
Staff for Signature/Send to MSC
Resolve Cmtsand Finalize
Staff Draft within District
Resolve KO Cmts/Finalize Draft
Staff Plan to KO/PA
Draft Initial AcqPlan
Finalize AcqStrategy
Conduct Market Research
Determine that formal ACQ Plan is required
272625242322212019181716151413121110987654321
Current Process Before – 27 Steps
After- 5 Steps
Value Stream Analysis Template
Lean – Value Stream Analysis
Value Stream Analysis Results
CurrentProcess
FutureProcess
ImprovementPossible
Steps 27 5 82%
Cycle Time (min) 20 5 75%
Touch Time (day) 5 1 80%
# of People 10 2 80%
Approvals 4 1 75%
Rework 70% 10% 85%
What to look for during process design Where do errors occur (errors cause
defects) Where does rework or redo loop steps often
appear? Wait time between steps or lost time in the
process / dead zones Unused outputs or pointless work Redundant / duplicate activities Inefficient movement of work between
process steps Inspections where a Poka-Yoke (automated
mistake proofing) would work better Bottlenecks in the process Excessive hand-offs in the process Excessive approvals built into the process Steps marked as “rush”
Processes that are experiencing excessive OT
Lack of or too much required documentation Is the fix or a solution planned in an
upcoming system change? Are there policies that need to be enforced? Do we need new policies? Is there a vendor who could perform these
steps for us? Do new features or functionalities need to
be added?
What to look for - continued
Errors due to a misunderstanding of the process
Errors due to inability to identify something correctly
Errors made by untrained personnel Errors due to someone ignoring the
process Errors due to lack of standards or
procedures
Human Errors / Issues to Watch For
Can the step be eliminated? Can the step be combined with another step? Can the step be reduced in some way? Can we eliminate inspections within the step? Can we eliminate approvals within the step? Should we slow down the step? Can we use fewer resources to complete the
step? Can we reduce wait time within the step? Can we ID an error in an automated way in the
step? Can we reduce the number of errors we make? Can we reduce hand-offs within the step?
Lean Questions to Remove Waste
Value Stream Analysis (VSA) Project
Defined the process to improve Tied to Strategic Plan (High Performance Organization)
Lean Facilitator Facilitation skills essential
Management Support Process Owner is the person who will sign off on changes This person MUST be on board
Charter Defines requirements, scope, expectations BEFORE you
start
Team Every step of the process must be covered Customers or stakeholders should participate or be
consulted This is where you achieve buy-in
Our Lean Process Tool Box
Synergies Between BPE and Lean 6σ• Provides a Broad Spectrum of Methods
Available for PI Initiatives• Lean 6σ Projects Feed Development of EBPM• Lean 6σ Provide “In the Trenches” Micro View
of Current Business Processes• EBPM and BPE Provide Macro View of Current
Business Processes• Promote Direct Action to Improve Critical
Areas of the Business• Promote Understanding and “Ground Truth”
About the Business Strengths and Weaknesses• Promote Learning and Knowledge Sharing• Promote a Common Language Within the
Organization
Lessons Learned• Management Support / Sponsorship is
Required Irrespective of the Level of Engagement
• Define Your Process Measurements – Simple and Relevant
• Find Allies in the Business – You Can’t Do It Alone
• Technology is Your Friend – Build Bridges to IT • Start Small With Focused Pilots – Don’t Try to
“Boil the Ocean”• Use Appropriate Methods and Tools for Specific
Problems• Not All Managers and Employees Will “Get It”
– Right Project, Right People at the Right Time• Stay Positive and Focus on Gains – Setbacks
Will Happen
Contact Information
Blue Cross and BlueShield of Nebraska
7261 Mercy Road South Bldg, 3rd Floor
Omaha, NE 68180
www.bcbsne.com
Bob Tippett, BBWork =
Rich Rozgay, MBBWork =
m