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Case Study: Increase the accuracy, compliance and timeliness of member communications in health insurance.

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Preparing member insurance communications is time-consuming, labor-intensive and prone to compliance risk. With increasingly strict regulations to deliver more accurate and timely benefit information, you need to be able to move with precision.

From start to finish, we simplify member communication development processes to ensure greater accuracy, compliance and timeliness of your content.

Faced with reviewing and updating thousands of paper-based health insurance notifications each month, Express Scripts needed a simplified way to improve turnaround times while increasing efficiency. Learn how this Fortune 25 Health Insurance Plan organization significantly improved productivity & risk management with their document processing.

Published in: Healthcare
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Case Study: Increase the accuracy, compliance and timeliness of member communications in health insurance.

  1. 1. Case Study: Health Insurance Payers From start to finish, we simplify member communication development processes to ensure greater accuracy, compliance and timeliness of your content.
  2. 2. Agenda • Background • The Client • The Challenge • The Solution • The Benefits • BlueRelay solution for the health insurance industry 2
  3. 3. 3 Preparing materials for the Annual Enrollment Period (AEP) is time-consuming, labor-intensive and prone to compliance risk. With increasingly strict regulations to deliver more accurate and timely benefit information, health insurance organizations need to be able to move with precision.
  4. 4. 4 Express Scripts (ESI) was looking to overcome the process challenges of approving member benefit communications.
  5. 5. The Challenge Approving member benefit communications: • Is a manual process involving high volume of paperwork • Requires physical routing of materials • Requires immense attention to detail, relying on the human eye in time-limited situations • Must abide with increasingly strict regulations requiring faster turnaround times • Requires an audit of the review process to ensure due diligence on every document 5
  6. 6. The Solution A phased approach ensured each pain point was addressed while improving the entire process as a whole. We focused on: • Document Routing • Attention to Detail • Process Efficiency • Optics and Visibility 6
  7. 7. The Solution 7 Document Routing
  8. 8. Solution: Document Routing Through the online workflow editor, the existing manual processes were converted into a digital format. • Assignments, decisions and deadlines are now automatically managed by BlueRelay, reducing overhead as these processes no longer need to be managed • Documents are automatically ingested, categorized and assigned to the appropriate workflow, eliminating the need for manual intervention • Valuable resources can now be devoted to reviewing the documents before they go out to members instead of being tasked with mundane tasks 8
  9. 9. The Solution 9 Process Efficiency
  10. 10. Solution: Process Efficiency By automating decisions, the process became more efficient and more reliable. • Previously, the only way to achieve parallel processing was to print multiple copies of each document • With BlueRelay, the system was now sending the documents to the next step in the approval process instantly and in parallel • Today, very few documents are printed and document approvals happen in parallel, reducing the overall waiting time for a document and ensuring the demanding regulatory guidelines are fulfilled 10
  11. 11. The Solution 11 Attention to Detail
  12. 12. Solution: Attention to Detail Iterative document life cycle processes are preserved by easily identifying and tracking small changes. • BlueRelay encourages this process by helping to identify which changes are made and evaluate whether they had a positive impact or not. • The side-by-side compare feature is used on every document before it is marked as approved. Without this tool, a simple typo, phone number change or sentence fragment could have easily slipped past the manual review process – not anymore! 12
  13. 13. The Solution 13 Optics and Visibility
  14. 14. Solution: Optics and Visibility By bringing the existing manual processes into a digital environment, everyone has real-time access to the status of all documents. • Quick highlights are provided in a graphical format on the Dashboard, yet the details of all assets are visible with a single click • BlueRelay’s custom report builder allows each individual to access the data that is relevant to them instead of having the system tell you what data you can access 14
  15. 15. The Benefits 15 Noticed Immediately Access to up to the minute status reports Real-time Information Overhead Reduced In Three Months Reassignment of tasks due to lack of need for manually updating spreadsheets
  16. 16. The Benefits 16 In Six Months Review cycle time efficiency improved by 75% Productivity Improvements In Twelve Months In Twenty Four Months Review cycle time efficiency improved by 300% Number of review cycles required reduced by 400%
  17. 17. BlueRelay for Healthcare and Health Insurance For many years, our team has worked closely with the healthcare industry to fully understand and address the risks associated with document review processes and member communications in order to provide a robust, industry-specific solution. 17
  18. 18. BlueRelay for Healthcare and Health Insurance As a result of this focus and in-house expertise, our clients find that the BlueRelay software delivers functionality and features that have not yet been met by other industry tools. • Customizable workflows • Configurable dashboards • Compliance checklists • Side-by-side document compare • Real-time reporting 18
  19. 19. BlueRelay for Healthcare and Health Insurance We ensure our clients can: • Deliver of timely and relevant communications, meet SLAs • Meet communication requirements set by regulatory bodies • Better manage large document review cycles for several programs without adding personnel • Increase agility in communication development processes • Access to up-to-the-minute status reports 19
  20. 20. BlueRelay for Healthcare and Health Insurance See how we are improving processes to increase member engagement and satisfaction for health payers. 20
  21. 21. 21 Connect with us to get a free trial or personal demo. http://www.slideshare.net/bluerelay https://twitter.com/BlueRelay https://www.facebook.com/BlueRelay/ https://www.linkedin.com/company/9365499

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