case study: increase the accuracy, compliance and timeliness of member communications in health...
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Post on 20-Jan-2017
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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.
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Agenda
• Background• The Client• The Challenge • The Solution• The Benefits• BlueRelay solution for the health insurance industry
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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.
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Express Scripts (ESI) was looking to overcomethe process challenges of approving
member benefit communications.
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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
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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
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The Solution
Document Routing
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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
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The Solution
Process Efficiency
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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
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The Solution
Attention to Detail
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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!
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The Solution
Optics and Visibility
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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
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The Benefits
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
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The Benefits
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%
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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.
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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
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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
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BlueRelay for Healthcare and Health Insurance
See how we are improving processes to increase member engagement and satisfaction for health payers.
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Connect with us to get a free trial or personal demo.
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