Within the next three years, the National Disability Insurance Scheme (NDIS) will provide funding to an estimated 670,000 Australians with a disability. And more than half of these people are now choosing to get the help of a plan manager.

My Plan Manager (MPM), is supporting 34,000 people who are receiving funding from the government, now processing claims for around 11% of the plan management sector.

In his second year at MPM, CTO Richard Hilliard’s focus was to deliver the largest transformation in the company’s history. To sustain growth, a step change was required to deal with limitations in process, system instability and business risk.

“The only lever at our disposal to deal with these challenges was to hire more people,” he tells CIO.

Against a backdrop of increased regulation of compliance, media scrutiny of the scheme and increased customer expectation, Hilliard says he has delivered key initiatives that will enable MPM to maintain its leading position and growth aspirations.

“With a whole-of-business effort focused on improved process, leading technology and significantly improved risk and quality guardrails, FY22 was a transformational year in MPM’s journey.”

Transact2Pay and a modern data platform

MPM processes more than 10,000 invoices on behalf of its clients every day.

In his 2021 entry, Hilliard spoke of improved OCR technology and an investment in robotic process automation. Hilliard says that while these initiatives delivered transformational benefits for MPM, the company knew it needed to go further with a deeper level of integration and data intelligence to continue to sustain the rapid pace of growth.

Much of the process for NDIS claims and payment still resided on a customer-built platform which was nearing end of life. Key activities were still highly dependent on manual intervention and human judgement in order to process a claim in accordance with a participant’s plan, often leading to errors, delays and dissatisfaction among participants and providers.

“Transact2Pay has flipped the process through automating key decisions via an automated rules engine build on our Salesforce platform,” Hilliard explains.

Rather than a staff member checking rules and budgets individually, the solution has automated the process, allowing staff to focus on true exceptions and adding client value.

“The complexity of this process is hard to overstate. There are many rules related to claiming that we have successfully managed to consolidate into a central rules engine.”

Hilliard says the results of these innovations have exceeded expectations. Now approaching the last stage of the transition, the combination of the invoice rules engine and further enhancing the existing OCR and RPA capability has significantly increased the volume of claims that can be automated.

“Where we previously saw up to 25% of claims fully automated, we now regularly see days where up to 60% of claims are able to be paid without MPM staff intervention. The results are clear: increased productivity and a reduced reliance on human capital in a constrained market. Manual tasks have been eliminated and turnaround times have improved. Importantly, the overall exposure to fraud and client vulnerability has reduced significantly,” he tells CIO.

Reporting overhaul

Hilliard and his team have also introduced a new data platform to overhaul internal reporting. New dashboards replace a previously a highly manual and time-consuming process done by a couple of people in the business. They provide users with up-to-date statistics on all key measures across the organisation.

“We’ve exposed our data warehouse to users via a tabular model to allow more detailed exploration of our data. We’re in a unique position to leverage vast volumes of claims and participant data,” he says.

This is a key pillar of My Plan Manager’s FY23-25 strategy. FY22 was about establishing the building blocks not only to transform its reporting capability but to deliver on its strategy of differentiation through data.

“FY23 will extend on the platform, employing ML and AI to deliver improved fraud detection and identification of client vulnerability. We will also be leveraging the dataset to provide ‘people like you’ and ‘next best offer’ functionality to provide recommendations to clients,” Hilliard adds.

Repairing a fractured relationship

MPM deals with over $5 million worth of NDIS claims daily, meaning that automation and an integrated customer experience is key. In his first year at the organisation, Hilliard’s focus was on repairing a fractured relationship between the business and technology.

“There was a real disconnect between what the business required and what the technology team was working on. We re-established a track record of delivery and reworked our project portfolio to ensure it reflected the business strategy more closely,” he says.

Now two years into the role, Hilliard says the business genuinely looks to the technology group to help achieve the organisation’s goals.

Hilliard spends time with execs and their direct reports to demonstrate core technology capabilities. And he holds a strategy and technology executive and board meeting every month to ensure tech decisions and projects are debated in the context of the strategic goals of the organisation.

“My personal KPIs and objectives are closely aligned with the CEO’s and include EBITDA measures, customer satisfaction scores and growth targets, as well as the normal delivery and technology objectives you would expect to see,” he says.

Staff in Hilliard’s team now have more of a ‘business mindset’, he says.

“They’ve educated themselves on business processes, and like I did when I started, spend time having catchups with business stakeholders, listening into calls, and trying to put themselves in their customers’ shoes. It is notable how they sought out advice from the business on operational and technical issues alike.”

Finally, Hilliard has continued to drive the way the company discusses its roadmap and portfolio. Workstreams are organised into strategic pillars; a product owner is leading each pillar and they work with business teams on priorities.

“The product owners meet several times a week with business stakeholders to ensure that we are working in a partnership. Having the product team report into the CTO is notable as it ensures that technology is always considered in how business challenges are approached.”

Byron Connolly