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New Provider-Led Plan Benefits From a Trusted Advisor | Insurance

Attentive senior man sitting at a desk and looking at a document.

CHALLENGE

A new provider-led plan in the Southwest was facing challenges upon entering the health insurance market. Would they need additional skills or capabilities for member acquisition, regulatory compliance, and utilization management? The organization was searching for a communications provider with Medicare expertise to help provide answers and solutions.

As a year-two Medicare provider, the plan was tasked with ensuring members receive program change documents such as ANOCs. The deadline for the document per the Center for Medicare and Medicaid Services (CMS) was September 30. The health plan quickly determined that they needed help. They needed a better way to manage the complex document creation process and improve member experiences, all within CMS guidelines.

RRD Healthcare Solutions answered their call. With its combination of 25 years of Medicare expertise, managed care-specific technology, and a diverse manufacturing platform, it was clear RRD could help. The partnership would guide them through their first season, ensuring that all compliance and all in-home dates would be met.

SOLUTION

The health plan ultimately ended up utilizing several elements of RRD’s healthcare solution set:

  • Document automation platform to automate the composition of CMS documents
  • RRD composition tools for the monthly automated creation of provider directories
  • Translation services embedded into the workflow for Chinese, Vietnamese, and Spanish
  • Print and fulfillment — as well as reporting

RESULTS

The client delivered their first season of ANOCs, compliant and on time, without any errata. In preparation for the following season, the relationship with RRD expanded. New services involved their pre-sales kits and collateral, welcome kits, ID cards, appeal and denial program, and billing statements.

In addition, RRD also supports their commercial line of business. RRD executes their welcome kits, ID Cards, letters, billing statements, and marketing materials. The program for this client now spans three facilities. One is specific to ID Cards, one for kitting and fulfillment, and one specializes in SLA-driven letter execution.

The professional relationship between RRD and the client remains strong and mutually beneficial. The teamwork is supported day in and day out by RRD’s navigator on the account. The navigator is even included in the client’s ongoing marketing meetings to add input and insight and recommend omnichannel solutions.