Healthcare |
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Overview
AVOLENT for Healthcare Payers
In response to rising premium costs, Healthcare insurers today are facing increased pressure to stay competitive and operationally efficient, while simultaneously increasing customer satisfaction and retention. In addition, trends to customer-centric health products such as consumer-driven health plans (CDH) and health savings accounts (HSA's) are changing the very nature of how health insurance is delivered. The difficulty of balancing costs, flexibility, and improved customer experience has never been greater or more important. Employer groups in particular are demanding that the day-to-day processes such as billing, member/roster maintenance, and customer support be responsive, accurate, and easy to understand. Too many health plans are forcing employer groups to take hours each month to mark up multiple invoices (HMO, PPO, Vision, etc.), estimate their own credits, and reconcile their own employee rosters across all invoices. Even worse, each step requires a call to customer support, finance, and/or membership maintenance, dramatically increasing the support costs and time invested for the health plan. Untimely adjustments to A/R and eligibility systems increase errors and termed member collections as well. For both employer groups and plans, these manual processes are expensive, time consuming, and fraught with errors.
Challenges We Address
eBilling and Cash Flow Optimization at a Top Health Insurance Organization
Responding to increased competition and rising costs, a top ten health insurance payer recently decided that it was going to transform itself into an industry e-commerce leader and aggressively seek new ways to grow its business. Its management team firmly believed that improving all aspects of its relationships with its 25,000 employer groups' three million members was an important key to growing revenues. The company's specific business goals were to:
- Increase employer groups' satisfaction through better online customer service
- Grow revenues to employer groups by using consolidated online information from multiple product lines and systems to cross-sell products
- Enable employees to spend more time on value-added activities by reducing the 75% of invoices that required manual roster changes or adjustments
The company surveyed 3,000 of its employer groups and found that they were overwhelmingly in favor of online invoice presentment and roster changes. So, after a rigorous evaluation process, it decided to partner with AVOLENT, which is now working with the company to roll out the following benefits to its employer groups:
- Increased employer group satisfaction due to a uniform online "look and feel" for all product lines
- Greater incentives for employers to buy additional products due to line-item consolidation of invoice information for all product lines from three different accounts receivable and billing systems
- Significant time and effort savings for the company and its employer groups through online entry and tracking of roster changes and reconciliation
- Simplified cash application through the electronic allocation of payments back to each accounts receivable system
- Improved planning and forecasting as the solution builds to 12 months of invoice history
Benefits We Provide
How AVOLENT Improves the Employer Group Experience
AVOLENT software allows healthcare insurers to streamline employer group processes such as invoicing, member maintenance, and reconciliation by replacing paper and manual tasks with an interactive online application. This allows a health plan to increase customer intimacy while simultaneously reducing operating costs and improving cash management. Healthcare insurers adopting AVOLENT can save $100,000-$400,000 per month by reducing hard costs and streamlining processes. Business benefits include:
- Increased customer intimacy
- A 50-75% decrease in invoicing costs, and 100% elimination of lost invoices
- A 75-90% decrease in costs of handling reconciliation
- A 40%+ reduction in billing customer support hours
- A 20%+ reduction in termed member collections
- A 3-15 day reduction in days sales outstanding (DSO)
- Instant HIPAA compliance with all employer group interactions
- A payback on initial software investment in less than one year
AVOLENT serves the needs of many customer segments with full HIPAA compliance, including fully-insured employer groups, self-billed, self-insured/ASO, individuals, Third Party Administrators (TPA's), brokers, and more. Using AVOLENT, they are able to:
- Securely view consolidated invoices online
- Manage employee rosters directly in the invoice, and see credits applied in real-time
- Review and resolve premiums collection disputes
- Search and view claims summaries
- Receive updates and status notifications via e-mail
- Pay online and receive electronic remittance
- Auto-reconcile employee lists with member rosters
- View and reprint old invoices, claims summaries, and statements
- Create customized analysis and reports
- Export to pdf, Excel, HIPAA 834, and other formats
And more!
AVOLENT also streamlines internal processes for Customer Support, Treasury, Finance, Account Management, Membership Management, and Marketing & Sales to ensure that all employer group interactions are consistent and accurate.
AVOLENT plugs into your existing enrollment, claims, and billing systems, and often requires no modifications to legacy systems. AVOLENT can be installed and running in as little as 90 days. AVOLENT Healthcare Advisory Board
- Linda Leigh Brock
- Jack Scanlan
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