Enroll, Retain & Manage Beneficiaries – Is Something Missing from Your Health Insurance Enrollment Platform?

Insurance
The Exela Blog

Enroll, Retain & Manage Beneficiaries – Is Something Missing from Your Health Insurance Enrollment Platform?

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by Peter Bohjalian

From coast to coast, many individuals face a complicated, uncertain path when participating in an open enrollment period. Evaluating the plan that best fits their needs, finding one that is affordable, and ultimately, working through an enrollment process creates obstacles and challenges for the individual.  This may not only cause issues for those seeking the plans, but also for the organizations offering them. If enrollment is overly complicated, it may prevent growth from reaching the levels that payers desire.

One viable way forward for payers and patients alike is to introduce a new insurance enrollment platform.   Greater value is realized by streamlining the user experience, and including customized, rules-based systems and features that can provide enterprises an effective way to offer consumers and businesses a simpler way to complete insurance enrollment processes.

Customization is Crucial

Because each plan has their own, unique operational pain points and areas for improvement, the ability to customize the software platform is paramount to successful enrollment and retention. Customization features can include integration with proprietary data analytics to grant management insights to propel targeted, multi-channel outreach to help drive results, and the ability to integrate with other proprietary software systems.  Further, health plan executives evaluating new enrollment platforms must look for ones that not only address immediate concerns like an overly-complicated user interface to sign up for coverage, but also have modular or service-based features that are available as additions to the base platform.

One platform may address completely the enrollment needs for a certain plan, but may not include billing capabilities. As a result customer account service processes become fragmented, with enrollment handled in one system and billing in another. Be sure to look for one flexible enough to support your unique operational needs in a truly end-to-end fashion through customization features, and modular platform upgrades to meet your specific operational desires.

Member Experience is Everything

Member experience is a key component when considering the successful enrollment and retainment of health plan members. There are a number of mission-critical ways that experience can be streamlined by implementing an end-to-end, platform-based approach to these endeavors.

First, it’s important that processes are genuinely streamlined by a platform-based approach, instead of simply repackaged. The type of health insurance enrollment platforms that really drive value meet two straightforward requirements – they keep processes simple, and are easy to use. Difficult navigation can keep enrollment down, and complicated platforms frustrate employees on the payer side.

The ideal platform should be equipped with features that preemptively catch application errors for potential members, and provide intuitive interfaces for each process from quoting to enrollment, reducing the overall time it can take consumers to enroll, and creating a more effective enrollment process along the way. Keeping a unified process from a technology perspective will help ensure that these platforms are assisting and not hindering your customers and employees.

Another way to improve enrollment and member experience is to provide features like plan comparison and selection, easy-to-use interfaces for enrollment, payments, report generation, claim tracking, and benefit coordination. In combination, these features can improve the customer experience.

Lastly, it’s important to select a platform that supports other types of communications and interactions as well – beyond a web-based portal. While the portal serves as an important base from which your other customer-focused operations can grow, advanced analytics combined with multi-channel outreach can be an effective way to engage members, and keep your retention rates high.

Guidance for Payers too – Not Just Members

Responsive platforms that have built-in features to respond to on-going, policy-based changes to the healthcare industry have proven to be among the most successful ones. These types of features help payers stay ahead of the curve on compliance, and proactively address changes that may affect their own enrollment processes.

Insurance executives should look for a platform that can effectively handle changes to insurance policies at both the federal and state levels, and be flexible enough to receive regular upgrades to help maintain operational compliance with stringent and evolving rules. When platform users on the payer side have confidence that their enrollment platform can effectively absorb and communicate changes in insurance policies, they can preemptively fix errors in overbilling, or communications. This approach can help increase operational efficiency according to a new study released by KLAS Research on this exact topic. (https://www.klasresearch.com/resources/reports)

To conclude, health insurance executives have much to balance in the process of running a successful organization. An enterprise-level digital platform to aggregate and run the most critical processes for gaining and retaining customers is a viable strategy to streamline both the enrollment process for customers, and operational processes for the insurance organization itself.

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