Understanding, experience and technology for success
MetricStream solutions enable the health insurance provider to build a robust, automated and integrated framework for risk and compliance management
June 07 2011 | Palo Alto, California: MetricStream Inc., the market leader in Governance, Risk and Compliance (GRC) solutions today announced that a Blue Cross and Blue Shield (BCBS)affiliate has gone live with the MetricStream GRC Platform for Enterprise Risk Management (ERM) and compliance with the Model Audit Rule (MAR). With MetricStream solutions, the company can automate and streamline the assessment and monitoring of risks. It can also build a reliable control framework in compliance with NAIC MAR.
The company, an independent licensee of the BCBS Association, is one of the foremost providers of health insurance in a US state. With a range of health plans, and a vast network of healthcare providers, the company is committed to providing its members world-class health and wellness solutions.
The financial health of an insurance company is determined by its approach to various risks related to investments, policy and claim reserves, premiums, payment of benefits, reinsurance, operating expenses and taxes. Most insurers have control mechanisms to manage such risks. However, the challenge lies in consistently assessing and monitoring risks and controls, and documenting them periodically. MAR compliance even requires companies to file reports certifying the effectiveness of internal controls.
To comply with these requirements efficiently and strengthen its ERM processes, the company decided to replace its manual, paper-based compliance processes with an automated system. The company also wanted to shift from ad hoc compliance and risk management initiatives to a more streamlined, centralized framework.
The company has established a set of over 60 predefined risks covering security and privacy, budgets, claims processing, external fraud, investment, billing and collection. MetricStream ERM Solution enables multiple risk assessors to assess these risks independently every six months. The solution then provides a consolidated average risk score. The entire process is automated and streamlined across the enterprise, enabling the company to identify, assess and monitor its risk profile with ease.
MetricStream NAIC MAR Compliance Solution provides the company an integrated platform to effectively link risks and controls, identify the appropriate controls and conduct audits to monitor their effectiveness. Issues that arise are immediately routed for investigation and remediation. In addition, powerful reporting capabilities aggregate control assessments and other MAR compliance data into comprehensive reports. They enable the company to gain real-time insights into the status of MAR compliance and risk management across the enterprise.
MetricStream is a market leader in Enterprise-wide Governance, Risk, Compliance (GRC) and Quality Solutions for global corporations. MetricStream solutions are used by leading corporations such as Johnson & Johnson, Philips Healthcare, Blue Cross Blue Shields, NASDAQ, SocieteGenerale, Citigroup, UBS, Constellation Energy, Subway, Woolworths, NetApp and American Airlines in diverse industries such as Healthcare, Pharmaceuticals, Medical Devices, Automotive, Food, High Tech Manufacturing, Energy and Financial Services to manage their quality processes, regulatory and industry-mandated compliance and corporate governance initiatives, as well as by over a million compliance professionals worldwide via the www.ComplianceOnline.com portal. MetricStream is headquartered in Palo Alto, California and can be reached at www.metricstream.com