Employee benefits enrollment can often be a daunting and confusing process for both employees and employers. With a multitude of options, complex jargon, and various deadlines to meet, it's understandable why many individuals find enrollment overwhelming. However, it need not be this way. By implementing a few simple strategies and adopting user-friendly tools, employers can streamline the benefits enrollment process, making it more straightforward and accessible for everyone involved.

How You Can Simplify Employee Benefits Enrollment

1. Clear Communication:

Effective communication is the key to simplifying the benefits enrollment process. Employers should provide comprehensive and easy-to-understand information about the available benefits and the enrollment process itself. This can be done through brochures, online resources, and informational sessions. By clearly explaining the purpose, advantages, and costs associated with each benefit, employees can make informed decisions that align with their needs.

2. Use Smart Technology:

Leveraging technology can significantly simplify benefits enrollment. Employers can utilize online platforms or benefits administration systems that allow employees to review and select their benefits electronically. These systems can provide an intuitive interface, guiding employees through the enrollment process step by step. By eliminating paperwork and automating the process, technology reduces errors, saves time, and enhances the overall experience.

3. Personalized Assistance:

While technology can streamline enrollment, some employees may still require personalized assistance. Providing access to benefits counselors or human resources representatives who can answer questions and guide employees through the enrollment process can be invaluable. These individuals can provide one-on-one support, address specific concerns, and ensure that employees understand the available options.

4. Deadline Reminders:

Setting clear and timely deadlines is crucial for benefits enrollment. Therefore, employers should provide employees with reminders well in advance of the enrollment deadline to avoid last-minute rushes or missed opportunities. These reminders can be communicated through various channels, such as email, internal messaging systems, or company newsletters, ensuring that employees are aware of the enrollment period and can plan accordingly.

5. Information and Training:

Investing in employee education and training can significantly simplify benefits enrollment. Conducting workshops or webinars that explain the basics of various benefits, their value, and how to make informed choices can empower employees. By providing educational resources throughout the year, employers can ensure that employees have the knowledge necessary to evaluate their benefits options and make informed decisions during the enrollment period.

6. Simplify Options:

Another way to streamline enrollment is by simplifying the available benefits options. While offering comprehensive benefits is essential, too many choices can overwhelm employees. Employers should carefully evaluate the benefits they offer, consider the needs of their workforce, and eliminate any redundant or underutilized options. By providing a curated selection of benefits, employees can focus on what matters most to them, making the decision-making process easier.

Experience Optimized Employee Benefits Administration

Employee benefits enrollment doesn't have to be complicated. By employing clear communication, utilizing smart technologies, providing personalized assistance, offering deadline reminders, investing in training, and simplifying options, employers can greatly simplify the enrollment process. Exela’s Spring simplifies benefit administration.

Spring Benefits is a cloud-based enrollment and administration platform for employers. It facilitates seamless plan creation, updating, and management of benefits. By harnessing the power of technology, Spring enables users to efficiently accomplish essential tasks like establishing a benefits program, setting up rates and rules for plans, and enrolling new employees into the program. The platform can quickly and efficiently maintain enrollment profiles for each employee, storing information such as employment dates, marital status,and a lot more.

Companies can empower employees to make informed decisions that align with their needs and ultimately enhance their overall satisfaction with their benefits package. A streamlined benefits enrollment process leads to happier employees, increased engagement, and a more efficient workplace for everyone involved.

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 ongoing, 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. (www.klasresearch.com)

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.

Learn more about Exela's Member Enrollment solution.

Nearly a decade ago, Harvard economist, David Cutler, famously called out Duke University Hospital for employing 1,300 persons to administer billing for only 900 beds. Apparently, that’s what it took in light of the many disparate requirements imposed by multiple payers (patients, insurance companies, the government) in every transaction. Nearly a decade later, healthcare automation offers efficient alternatives in billing as well as many other business processes.

Automated claims processing

As a threshold matter, automating healthcare solutions requires effective health information management. Health information management holds significant promise with regard to eliminating delays and denials in the claims process, which impact payers, providers, patients, and public health in general. Effective health information management not only directly addresses known issues in the claims workflow, but it is also a crucial first step in automating points along that workflow for optimal use of human capital, ROI optimization, and enhancing employee- and patient/consumer-experience.

To wit:

- For every process a payer or provider automates, there’s less need for manual intervention.

- Automated processing enables full visibility throughout the process.

- Intelligent data analytics tools help ensure efficient compliance efforts and enhance data privacy, routing related documents for the most efficient and appropriate reconciliation.

- Predictive analytics tools help providers and payers plan for uncertainties, including appeals and resubmissions.

By way of example, Exela’s deployment of our custom, self-service, rule-based healthcare solutions saved a top 10 payer an impressive 35% in the cost of processing claims and amounted to a 50% reduction in cycle time and a 20% reduction in resubmission rates. In addition, increased transparency for payers, providers, and members vastly improved employee- and patient/member-experience and reduced the demand for customer-service interactions. You can learn more in this case study.

Automating payments

Automating billing can be a game-changer by:

• Reducing the number of persons dedicated to the process, reducing time spent, and errors associated with, manual keying.
• Unifying payment data from multiple channels such as paper checks, debit transactions, collection procedures, etc.
• Enabling an improved patient communication strategy.
• Introducing other valuable efficiencies into the billing process such as HIPAA-compliant lockbox solutions.

In fact, we at Exela know how valuable such steps can be because we’ve seen it first-hand in solutions we’ve provided to our customers. For example, in the case of a major academic health system whose outdated payment operations had been mired in manual, error- and loss-prone processes, we deployed our Patient Financial Services suite to streamline information ingestion, facilitate communications, and optimize workflows, with the result being a 25% reduction in full-time employees needed for these operations and a 30% increase in collector efficiency. You can read more about it in this case study.

In addition to streamlining claims by avoiding denial of payment through improved coding, delivery of clean claims, and facilitating all related inter-stakeholder communications, automation can optimize revenue integrity through, among other things, data mining for the purpose of predictive analytics and revenue forecasting, all in the service of identifying and recovering all amounts in the most effective and efficient manner. For example, when a large healthcare system wanted a way to maximize reimbursement under their many payer contracts (all of which had different requirements, terms, and conditions), Exela deployment of its healthcare automation solutions resulted in 99.6% accurate reimbursement and identified 98.4% of underpayments and calculated predicted reimbursement under all payer contracts. “We look forward to continuing our relationship with Exela for years to come,” commented the customer in this case. “The contingency, success fee based engagement has provided an extremely positive, financial bottom line return, while requiring minimal staff time on our part...”

In addition, our medical lockbox solutions support providers in managing (and reducing the costs associated with managing) a high volume of receivables payments. And our newly-launched Real Time Payments solution can streamline the collection of remainders from patients using secure messaging and convenient payment options (via text message with payment options).

Automating accounts payable

It’s not just the core businesses of stakeholders that benefit from automation. For example, another of Exela’s customers, a national urgent care provider, had been processing more than 50,000 vendor invoices per month, resulting in lost documents and delayed payments to vendors, before turning to Exela to fully automate its burdensome paper-based workflow. In addition to streamlining payment to vendors and lowering the incidence of defaults and discrepancies, the user-friendly interface equipped the provider with the tools needed to readily address discrepancies if they arose and permitted the provider’s vendors to check invoice status online.

In the case of a major pharmaceutical company with a global footprint and driven by constant research and development, Exela was able to harmonize, digitize, and automate the more than 50,000 incoming invoices from 40 different business areas in 19 different countries through a custom-tailored combination of digitization services, data extraction, reporting, and remittance.

Automation Enrollment

Open enrollment is a payer-specific issue, and it’s always challenging. With ever increasing pressure to outperform the previous year’s results, there’s always a need for process innovation to meet increasing demands. Pressures are compounded by a short enrollment timeframe and employees who find the process confusing. The result is numerous queries and insufficient enrollment documentation. A large insurance company customer of Exela had been struggling with this scenario to the point that its satisfaction scores with providers and members were being severely impacted. Exela designed a universal intake and workflow solution to manage all the various modes of communication between the payer and the employees/potential members. In less than 90 days, Exela delivered 240,000 enrollment installations a month at a quality of 99.5% with significant cost savings in the form of reduced call volume and reduced pending items. Customer satisfaction soared.

Benefits to patients

The administrative complexity of the U.S. system also burdens patients, whether they are deciphering bewildering bills or shuttling records between providers. Three-quarters of consumers report being confused by medical bills and explanations of benefits. A Kaiser Family Foundation survey of people newly enrolled in the health insurance marketplace found that many were not confident in their understanding of the definitions of basic terms and concepts such as “premium,” “deductible,” or “provider network.” Insurers and employers spend an estimated $4.8 billion annually to assist consumers with low health insurance literacy, according to McKinsey.

For the full story on how technology can solve costly inefficiencies in the health industry, be sure to check out our Q4 Edition of PluggedIN: Tell Us Where It Hurts: How Tech Can Heal Healthcare.

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Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511963/

https://www.streamlinehealth.net/HIM-blog/revenue-integrity-can-organization-best-achieve/ https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/promoting-an-overdue-digital-transformation-in-healthcare

Digital transformation in healthcare continues to be a key topic in many healthcare leaders' minds. Healthcare providers of every size face the same challenge of improving patient care and engagement while managing costs. However, many obstacles create complications including limited staffing, outdated systems, payer contract complexities, and more. By embracing digital transformation, healthcare providers can begin to tackle these obstacles and accomplish their goals for the future.

Digital transformation in healthcare affects many aspects of the business from freeing up resources that can be devoted toward patient care and increasing patient engagement to improving operational and financial efficiencies. With AI, automation, and technological advancements, the healthcare industry stands to gain improved processes, quicker payments, and fewer claims denials.

Digital Transformation in Healthcare Starting with Automated Claims Processing

Claims management and processing is a major operation in need of digital transformation in healthcare. This is often a thorn in healthcare providers' sides because of its complexity. Claim denial rates are between 6% and 13%, which eats away revenue.

These statistics highlight the importance of submitting clean claims right from the start. However, this is easier said than done especially when relying on manual processing and outdated systems. Many healthcare claims are being denied for simple reasons such as a spelling error, incorrect coding, missing patient identify information. Given that healthcare organizations' resources are stretched thin, it makes sense that claims processing would be vulnerable to human error.

Once again, digital transformation in healthcare can step in and smooth the process. Exela is a leading claims processing provider with a solution that enhances claim processing by unifying data from all incoming communication channels, performing pre-submission checks to create clean claims, and intelligently routing correspondence for optimal processing using automated decisioning. Exela’s Healthcare Claims Processing solution reduces denials and resubmissions by applying business rules to produce clean claims prior to submission. Using automation and artificial intelligence, Exela increases transaction processing rates and accuracy while reducing manual processing and rework.

Take Complex Claim Processing Further

According to a 2021 CAQH report, only 21% of medical administrative transactions are digital while the rest are paper. Exela leverages exclusive vendor contracts with leading health plans for complex paper claims processing.

Embrace digital transformation further with Exela's PCH Global solution, a powerful digital platform that not only provides a single point of access for claims management but provides a central bridge between all parties including the provider, payer, and patient.

PCH Global promotes clean claim submissions by identifying certain-to-denied claims, thereby improving first-pass rates. Its iterative feedback loop technology helps the system continuously learn and improve to identify errors enabling proactive claims management with system flexibility as your contracts change.

Finally, the system automatically tracks and records any addition, deletion, or modification to transactions along with user reference and timestamps providing clear audit trails and ensuring full compliance.

Digital Transformation of Remittance Payments

The 2021 CAQH report determines that the healthcare industry could save 48% of annual spending by transitioning to fully electronic transactions. Manual processing significantly slows down operations especially when human errors are taken into consideration. Automation streamlines this process reducing errors, posting payments quicker, and improving overall efficiency making it a terrific place for digital transformation in healthcare.

Exela's Medical Lockbox simplifies the healthcare payment process by digitizing and automating manual, paper processing tasks. Using a state-of-the-art scanning platform and intelligent OCR/data capture technology, Exela’s Medical Lockbox solution converts paper EOBs from any source into 835, electronic remittance files, payment reconciliation and posting to the healthcare organization's medical billing system. By streamlining the payment path, Exela’s Medical Lockbox solution reduces the time it takes for payments to post and allows quicker access to deposited funds. Submitting secondary claims or patient billing, depending on the patient’s coverage, makes the payment cycle faster from Primary, Secondary, Tertiary or Patient payments.

Not only does Exela's Medical Lockbox streamlines payment processing, but it also features a web-based denial management tool designed to increase the recovery rate on denied claims. This web-based management tool presents the original claim and all related remittance information in a single view simplifying the process for users to adjust the claim, bill the patient, or appeal the denial. Insights are gleaned through reimbursement metrics presented within Exela’s Medical Lockbox’s configurable reporting function. These insights are valuable with billing system audits and contracts negotiations.

Automated Contract Management

Healthcare payer contracts vary greatly, each having different policies, regulations, and parameters. The contracts of each insurance company are often revised and updated annually so healthcare organizations need to renegotiate several payer agreements every year.

Keeping track of the current contracts and any annual updates is an enormous task that burdens healthcare resources. Without a handle on contract management, healthcare organizations are vulnerable to underpayments which affect their bottom line. Contracts and underpayment management are yet another place where digital transformation in healthcare is needed.

Exela’s Revenue Integrity solution automates the contract management process, document scanning, indexing, profiling, loading and maintaining all third-party payer agreements. Agreement terms are tracked and providers are presented with notifications of important dates as well as amendments and updates. Instead of using limited resources to keep track of contracts, automation is ready to step in.

Exela’s Revenue Integrity solution also offers predictive contract modeling that provides accurate reimbursement calculations for current and future contractual agreements. By providing multiple scenarios and utilizing the most recent one-year patient data set, the platform presents the net dollar and percentage increase or decrease.

This solution also identifies retrospective, current and prospective underpayments from all contractually obligated third-party payers.

Summary

Digital transformation in healthcare opens many doors and it’s time providers embrace the opportunities available to them. AI and other technologies are ready to streamline antiquated processes, increasing efficiency and accuracy while freeing up personal time.