US Health Insurer - IPD SolutionsPartner Profile


The Provider has nearly 36 million members with health, life, and dental coverage. Its extensive care offering means the organization receives millions of documents every month, including multi-page group enrollment documents. It’s 45,000 employees are tasked with processing hundreds of thousands of enrollments annually.

Challenges


Employees were plagued with low-value manual tasks and dependent on multiple non-integrated systems, which slowed enrollment cycle times and diminished its competitive edge. Leveraging its administrative existing systems, the Insurer selected IPD Solutions as its partner to optimize processes and create an operational transformation.

Objectives
 
  • Provide 98%+ accuracy of member-level transactions
  • Reduce average cycle time for enrolling groups from 30 days to 24 hours
  • Cost saving through staff reductions, increased productivity
Solution


To stay competitive, gain valuable new members, and begin billing earlier, the Insurer implemented a process and content management solution from IPD. While leveraging the client’s existing systems environment, IPD’s powerful solution enabled the client to meet its enrollment service and productivity goals and provided substantial savings.

Many of the once manual functions associated with enrollment — capture, qualify, price, approve/enroll, notify and bill— are now automated by IPD’s solution. Medical review and underwriting were also successfully automated and optimized, including the risk assessment before the policy issuance.

IPD’s software solution delivered all pertinent information for speedy assembly, evaluation and decision-making, increasing knowledge worker productivity on high-value tasks. Now enrollments are processed in 24 hours opposed to 30 days, providing every member with the same VIP service previously available only to select groups. IPD’s solution also decreased the amount of staff needed and enhanced the accuracy of transactions.

Recognizing that providing access to quality health care becomes more expensive every year, the Insurer stays competitive by providing affordable coverage, “leveraging technology to decrease medical errors and improve outcomes, and streamlining administrative function that add cost the health care system,” according to its recent Social Responsibility Report.

See the U.S. Health Insurer case study.