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How COVID Made Document Automation a Medicare Industry Must for 2021

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Consider Medicare Advantage organizations and the thousands of important, compliance-driven documents they create every plan year. Manual composition, versioning, and translations of these documents has been the norm more often than not, leaving the door open for costly errors and inefficiencies. And with the necessary push for employee safety amid a global pandemic, these manual processes were made even more challenging by the spike in employees opting to work from home.

“Medicare Advantage plans were already experiencing bottlenecks,” says Nicole Williams, Director of RRD Healthcare Solutions. “Delays were related to ANOC and EOC versioning and translation due to the increased number of plans and a greater demand for alternate formats. COVID has just exacerbated the issue.”

Now is a smart time to invest in automated solutions. According to research from Inference, 65% of healthcare IT decision makers plan to invest in automation technology in 2021 as a result of COVID-19. Additionally, 77% agree tools that allow them to build and manage their own applications are important to their automation strategy. Those two numbers should only grow with time. 

Powered with an understanding of text, context, and meaning, automation can unlock vital efficiencies in document processing.

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Document Automation in Healthcare
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A different perspective on compliance documents

“Most of our Medicare Advantage clients view the creation of ANOCs and EOCs as a painful task,” says Steve Keca, Solution Director of RRD Healthcare Solutions. “We think it's important to do what we can to change that perspective. These organizations can use their existing plan knowledge and data sources to really unlock the hidden potential for automating document generation. This even includes automating translated versions.”

The COVID pandemic has driven this need into 2021, as health insurance companies are seeking ways to become more agile and resilient amid the pandemic. Document automation technology can also play a key role in improving both customer and sales/broker relationships by meeting the preferences of tech-ready audiences.

“An increasing number of plans want to produce digital versions that engage more than a PDF,” Keca adds. “Having connected solutions that tap into content in a way that can be leveraged for e-presentment is key. And making this complex content available in controlled ways to the sales process adds even more value.”

As the volume of plan documents continues to expand year in and year out, and the internal teams to produce these documents stay the same or shrink, manual processes will need to take a back seat to innovation designed specifically to manage these onerous tasks nimbly. 

The burden of manual processing 

Creating, updating, and maintaining plan documents manually is burdensome because most are variable by nature. The content varies in complexity and quality with plan variations, and the model provides significant opportunity for modifications. In other cases, content that can be repurposed is often unnecessarily duplicated, which drives more manual changes.  

In an industry that demands timeliness and accuracy, manual processing yields long turnaround times and a high incidence of errors that are costly to remediate, e.g., erratas. Additional challenges that only complicate the manual approach commonly include:

  • Versioning at a plan level 
  • Time intensive proofing workflows
  • Alternate format requirements (e.g., languages, large print, 508c)
  • CMS model language releases (new plan year changes)

In 2020, U.S. healthcare companies cited reducing costs, retaining customers, and improving the ability to meet customer demands as their top three automation priorities [source]. It’s likely those priorities will stay put for 2021. 

“I think the philosophy ‘simplification through document automation’ is one that can elicit positive change here and help organizations turn priorities like these into achievable goals,“ says Williams.

The efficiency promise of document automation 

Those of you who prepare AEP plan documents are all too familiar with compressed timelines and strict deadlines. When you mix in time-consuming, error-prone tasks, the potential for a negative impact on customer communications (and even brand integrity) only grows.

By leveraging the right technology to automate processes for ANOC, EOC, and SB composition, companies can ideally leverage existing text and data from their content repository as a starting point. Along with complex, data-driven templates, the plan can produce complete, accurate, and compliant documents weeks sooner than legacy manual systems.  

With versions of health plans multiplying, this kind of efficiency will only become harder to achieve through manual processing. Additional efficiencies through document automation include:

  • Expedited proofing and review cycles
  • Reduced staff and stakeholder intervention and coordination
  • Elimination of errors (and erratas)
  • Streamlined document tracking 
  • Optimized handling of alternate formats

Document automation at work   

More than 24 million people (39% of Medicare recipients) have enrolled in Medicare Advantage plans, driving competition among payers to capture more of this growing population [source].  Entering new markets with new participants requires organizations to produce accurate and compliant documents relative to those service areas. 

Carrying out federally mandated requirements for the ANOC and EOC demands a lot of time and attention. Achieving compliance on a large scale is nearly impossible for organizations that rely on mostly manual preparation processes. 

“The creation of these documents requires review and approval of several teams within a health plan — marketing, compliance, pharmacy, customer service to name a few,” says Keca. “This makes the manual review process super challenging.”

Accountability for updating materials, including bid submission, desk review, benchmarks, and print production leads to pressure intensified by manual techniques.

According to Williams, “The devil is in the details: concurrent translations and 508 tagging, documents that are truly print ready, multichannel fulfillment; these can become a bottleneck if not properly managed.

Document automation, thankfully, offers relief and numerous benefits when it comes to compliance. RRD recently implemented our own document automation solution to transform processes for a mid-size insurance carrier struggling with the creation and versioning of their Medicare compliance documents. 

Through our own purpose-built software, document automation is helping this client: 

  • Ensure plan materials match annual bid submissions with automatic updating and generation of versioned plan materials (critical, as the number of versions is increasing)
  • Incorporate automatic model updates and synchronize documents with the latest updates to ensure compliance year after year
  • Generate 508C PDFs, English, Spanish, large print, and 508 compliant AOC, EOC, and SB documents for all plans

Head here to see more of that success story and see how we helped our client automate processes that enabled vast improvements in on-time, accurate document delivery.