CUSTOMER SPOTLIGHT

Delta Dental of Michigan
Rules for dental coverage
Claims processing is highly rule-intensive, requiring frequent changes to insurance software. Increasingly, organizations are solving this problem with ILOG’s business rule management systems (BRMSs).

Delta Dental of Michigan (www.deltadentalmi.com) recently joined the growing number of insurance carriers that have selected ILOG JRules, our top BRMS product, for their claims processing applications. ILOG JRules will centralize the business rules used by the company to make them easier to access, modify and deploy.

With nearly 5.5 million members and affiliates in Ohio and Indiana, Delta Dental of Michigan is the leading group dental benefits provider in the U.S. Midwest. It is also a member of the Delta Dental Plans Association, a nationwide system of independently operated dental health service programs.

The association provides coverage to more than 47 million people and operates the largest network of participating dentists in the United States. ILOG JRules’ advanced rule management capabilities will enable Delta Dental of Michigan to roll out innovative products faster and continue to provide outstanding service to its policyholders.

“We wanted a business rule management system that would meet our ease-of-use, ease-of-integration and performance requirements, given that we process over 10.9 million claims annually, supporting a large network of members,” says Brenda Laird, director of Information Systems and Services, Delta Dental of Michigan. “ILOG’s business rule management system provides us with a comprehensive solution that addresses the requirements of a large provider like us. ILOG BRMS integrated easily into our service-oriented architecture.”

A BRMS-based claims system enables an insurance company to centrally store, manage and track rules across the entire claims process. Leading insurance carriers rely on ILOG’s BRMSs to automate decision making for claims validation, fraud detection, case assignment, task management, adjudication, payment and settlement tasks, and regulatory compliance.

With pricing policies and promotions becoming increasingly complex, Essilor’s regional managers determined that their existing systems would have difficulty supporting the new initiative. Pricing rules were hard-coded in their applications and could take months to change, and customizing offers for specific regions required a large-scale programming effort. To overcome this problem, Essilor decided to use ILOG Rules for .NET, a business rule management system (BRMS) that works seamlessly with the Microsoft .NET platform. It will centrally store Essilor’s pricing policies and customer contracts for each region, making them easier to update and deploy. It will also accelerate Essilor’s time to market for new pricing solutions, and easily accommodate local requirements, regional growth objectives and corporate compliance policies.

“After a first successful experience with ILOG JRules for our margin analysis application, we considered that to reach our goal we needed to implement flexible sales management policies,” says Philippe Marchan, director of the project at Essilor. “The best solution was to integrate our enterprise resource planning system with Rules for .NET.”

Essilor is already considering ILOG Rules for .NET for other projects, including an order routing application for determining which lab can most quickly fill a customer order based on costs and available resources and skills.

SoftBank Telecom
Out front with rules
Competition has driven telecommunications companies the world over to offer increasingly diverse and complex services that in turn have to be supported with increasingly diverse and complex pricing and ordering systems.

SoftBank Telecom’s solution for outdistancing the competition is based on ILOG JRules, our top business rule management system. The Japanese local exchange carrier (www.softbanktelecom.co.jp) has used ILOG JRules to move hard-coded rules buried in existing systems to a central repository to make them easier to manage.

ILOG JRules halved the projected time for migrating the rules to the centralized system, and shortened the time needed to update the rules by 80 percent. It reduced more than 160,000 lines of computer code to just 1,000 business rules, and made the rules accessible to both policy managers and IT personnel. Now, the telecom can easily access its order validation and pricing rules to quickly implement promotions and respond to changes in the market. It can also automate its error checking procedures to reduce risks and accelerate rule authoring and deployment.

“We selected ILOG JRules because of ILOG’s leadership in the BRMS market and its expertise with telecommunications companies both here in Japan and worldwide,” says Hiroshi Yanaga, general manager, Second Development Department, SoftBank Information Technology Division. “We felt they understood our market and our challenges, and were able to help us deploy our application in six months, allowing us to more quickly leverage the competitive advantages of more agile ordering and pricing systems.”

Hapagfly recently put into service a crew pairing solution that uses ILOG CPLEX, the leading mathematical programming product. It applies parameters that include employees’ skills, experience and preferences, as well as company policies, union rules and labor regulations, in assembling crew pairings for Hapagfly and its sister company, Hapag-Lloyd Express.

Both airlines are part of the TUI Group of travel and tourism companies (www.tui-group.com). They operate more than 50 planes with destinations throughout Europe. Crewing these planes are 2,000 cockpit and cabin personnel trained to perform certain tasks on specific jets.

Jointly developed by Hapagfly (www.hapagfly.com) and the Operational Research Department of the Martin Luther University of Halle Wittenberg, the crew pairing application taps TUI’s Integrated Disposition Planning and Statistics System (IDPS), a central IT system for managing core business processes and resources.

The solution, called IDPS-CrewOptimizer, has shortened the crew pairing time for the two airlines by more than 50

“ILOG supported us in an excellent manner to solve a very complex mathematical model,” says Dr. Manfred Wild, head of IT at Flight Operations and IDPS, Hapagfly. “We at Hapagfly benefit daily from ILOG.”

it vision
Interface maps telecom sites
Telecom has always had extremely complex networks, and industry privatization, Internet access and mobile technologies add to this complexity daily. Navigating any telecom network without complete visualization can be risky and expensive.

Specializing in solutions for planning, designing and operating telecommunications networks, it vision (www.itvisiongmbh.com) offers the NETx product suite for handling the numerous challenges posed by a broad network of multivendor equipment and interconnected business processes.

A crucial part of this suite is Site Connector, a graphical user interface (GUI) that provides a complete network map to clearly show lines, equipment and other resources, as well as their operating status. It builds on NETx functionality for intuitively creating and routing connections using operator-provided information.

The GUI is based on ILOG JViews Telecom Graphic Objects (TGO) and ILOG JViews Maps. ILOG JViews TGO displays telecom assets with realistic images, and ILOG JViews Maps brings the assets together, georeferencing their locations and interconnections.

“NETx is a complete family of applications for managing telecommunications networks,” say Dr. Michael Mallien, manager of customers and projects, it vision. “ILOG JViews enables us to give each customer the depth of network visualization needed to be truly competitive in this high-pressure industry.”

Both it vision and ILOG are members of the TeleManagement Forum (www.tmforum.com), which provides leadership and guidance in the telecom industry.