Slipstream Blog

Kickstarting Claims — Simple and Flexible Best Practices for Claim Review and Approval

Written by Garrett Bailey

A Clean Slate — Claims Out-of-Box

For a long time now, the life sciences industry has been very interested in reaching a point where their content is modular for omni-channel delivery. One of the biggest prerequisites for reaching this ideal is having a well-curated, robust, accurate, and compliant Claims Library.

Veeva Vault PromoMats provides powerful tools for managing the lifecycle of product claims. However, the out-of-box process for claim review and approval provided in PromoMats is largely manual and vague, lacking task assignments, security, and role-based approval that is critical before implementing a piece of language into promotional content.

This article explores best practices that our experienced team has discovered for optimizing the claim approval process, particularly for life sciences organizations just starting on their claims journey.

Understanding the Need for a Structured Workflow

In its default configuration, Veeva Vault's claim review and approval process is manual. This means that claims are reviewed and approved without the use of automated tasks or roles. Essentially, whoever has access to edit claims can change their state, including making them approved for use. While this simplicity can be beneficial for small teams in a straightforward environment, in our experience, it often falls short in the complex or regulated environments of pharma where accountability and traceability are paramount.

A structured approval process is essential for ensuring that claims are reviewed efficiently and accurately. One way to approach this requirement is to introduce a task-based workflow, governed by a Librarian, that allows for the dynamic assignment of reviewers and approvers. This ensures that the right people are involved at the right stages of the process.

A Good Start

Our recommended starter review process for claims involves sending a task to the Librarian to triage which users/roles should review and approve the claim. Since these users/roles tend to differ depending on the nature and context of the claim, the easiest way to ensure flexibility when you are just starting out is to allow your Librarian to make these determinations based on criteria, SOPs, and their own expertise.

Here’s how this can be implemented:

  1. Initial Submission: When a claim is submitted, it triggers a task assigned to a Librarian.
  2. Triage by Librarian: The Librarian reviews the claim and determines the appropriate internal users who should be involved in the review and approval process.
  3. Adding Participants: Using the "Add Workflow Participants" feature, the Librarian assigns the claim to the selected reviewers.
  4. Review and Approval: The assigned participants review the claim, provide feedback, and approve or reject it as necessary.
  5. Final Approval: Once all reviewers have approved the claim, it moves to the final Approved state or is returned to Draft for revision and resubmission.

Again, this workflow ensures that claims are reviewed by the appropriate experts, reducing the risk of errors and improving compliance with regulatory requirements. Overall, this will result in a well-curated, clean, reliable claims library.

Implementation

Implementing and optimizing workflows can be complex and time-consuming, especially considering how many hats we are all wearing just on a daily basis. This is where Slipstream IT services come in. Slipstream IT specializes in helping pharmaceutical companies implement and enhance their Veeva Vault claims management processes with the highest level of excellence and white-glove service.

Slipstream IT can provide the following services to help you achieve an optimized claim approval process:

  • Workflow Design and Implementation: Slipstream IT can design and implement customized workflows that meet your specific needs, ensuring that your claims are reviewed and approved to high standards. Our consultants are experienced and committed to your organization’s success in the IT and compliance space above all else.
  • Training and Support: Slipstream IT offers training and support to ensure that your team is fully equipped to use the new workflows effectively. We provide live training sessions, recordings exercises, and quick reference guides for a well-rounded experience.
  • Ongoing Optimization: We at Slipstream IT want to be your partner for the long haul — providing ongoing optimization support services to ensure that your systems continue to meet your evolving needs. We offer competitive, flexible support plans to ensure that your systems don’t miss a beat and are operating at the highest level of efficiency.

Conclusion

Optimizing the claim approval process is essential kickstarting your modular content journey and ensuring compliance, speed, and accuracy in building your claims library. By implementing structured processes that leverage flexible, context-specific participation, you can ensure that claims are reviewed by the right people at the right time with the right result.

For pharmaceutical companies looking to enhance their claims management processes, we would like to partner with you to provide the expertise and support needed to implement workflows and ensure ongoing optimization. By leveraging Slipstream IT's services, you can streamline your claims management and focus on what you do best — developing life-saving medicines and technologies.

To learn more about how Slipstream IT can be your partner on the modular content journey, please visit www.slipstream-it.com/schedule-meeting. We look forward to meeting you!