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Automating a Manual Process Helps Reduce Risk and Errors | Insurance

Smiling elderly spouses paying bills online using laptop

Automation tool frees knowledge experts from tedious manual document processing

CHALLENGE

A leading managed care organization (MCO) needed help efficiently producing, mailing, and managing CMS-regulated materials. It was essential to keep their members informed about the latest plan updates.

This MCO offers different Medicare plans in different states. As such, they were required to mail multiple versions of lengthy documents, including some that exceeded 200 pages. Versioning these documents is a time-consuming, labor-intensive, manual task, which often results in errors. Combined with traditionally tight turnaround windows for CMS approvals and in-home dates, this is typically a chaotic process for many MCOs.

To keep from falling victim to these circumstances, this organization had developed two homegrown programs for versioning their Medicare documents. One was for Summary of Benefits (SOBs) and Evidence of Coverage (EOC) materials, the other for Annual Notice of Changes (ANOCs). Unfortunately, after several years, the client’s marketing department was still challenged with reducing errors, meeting deadlines, and avoiding possible CMS fines.

It would take a multi-step (and multi-year) process with an experienced partner to streamline the processes at hand.

SOLUTION

In the first year of the process with this MCO client, RRD Healthcare Solutions began with an assessment. The existing processes were analyzed to determine the best way to deploy RRD’s document automation tool. After the first season ended, new best practices were established to optimize the program.

By the second year, the client saw improvements in turnaround times, document control, and error reductions. RRD’s document automation tool was fully integrated into the MCO’s operations. They successfully eliminated extensive manual processes that had plagued their Medicare materials production for years. Reduced cycle times, consistent content, improved accuracy, and streamlined processes for alternative formats were achieved. This led to the production of in-language, large print, and 508 compliant versions of SOBs, EOCs and ANOCs.

The client’s marketing, product, and regulatory teams continued to reduce error rates and increase document compliance metrics. Their knowledge experts were finally freed from tedious manual document processing, allowing them to focus on content quality and accuracy.

The client now has the time to manage documents for multiple project lines. They also have better control over document changes and enjoy day and night access to online tools. The solution has become an integral part of their overall workflow. RRD Healthcare Solutions now helps them navigate all facets of their production process, from document composition to compliance to final USPS delivery.