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Small Group & Individual Process Improvement

Process Redesign and Technology Enablement for a paperless enrollment and underwriting workflow for a Large, East Coast Healthcare Payer

Small Group & Individual Process Improvement

Process Redesign and Technology Enablement for a paperless enrollment and underwriting workflow for a Large, East Coast Healthcare Payer

Overview:

Process Redesign and Technology Enablement for a paperless enrollment and underwriting workflow for a Large, East Coast Healthcare Payer

Business Issue:

With Healthcare reform resulting in an increasing number, type, and complexity of Individual and Family applications received, this Payer wanted to redesign their individual enrollment process to realize process efficiencies and improve customer and agent satisfaction.

Actions:

  • Implemented “Proof of Concept” pilot, creating a paperless enrollment and underwriting workflow and case management process using off-the-shelf Microsoft Operating System and Office Products

Results:

  • Identified technology improvements eliminating the need to key family application information into multiple systems
  • Improved agent and customer relations by increasing the number of touch points in the process and improving the accuracy of application status information provided
  • Decreased maximum process times up to 50% for evaluating and underwriting an application
  • Developed and implemented a “triage” approach to underwriting resulting in 42% of applications completing the evaluation process within 2 days of receipt

What Our Clients Say

"Our team spent a lot of time debating whether or not to hire an outside consultant for this project, but partnering with RubinBrown was one of the best strategic decisions we could have made. The level of service and their commitment to meeting our specific needs blew us away. We know we chose the right ERP system, but that's because we chose the right consultant to help us get there."

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