Most health insurance companies did not wait to start preparing for the massive changes set to affect the healthcare industry. They know they are coming sooner than you might think. In fact, open enrollment begins on October 1, 2013, and it will last until March 31, 2014 meaning summertime has been anything but slow for insurance companies.
That is because in 2014, insurance companies will no longer be able to deny coverage to patients based on pre-existing conditions, or factors related to age, gender or health. Health spending, for that matter, is expected to grow at a rate of 8.3 percent in 2014. And the new Health Insurance Exchanges (HIX), set to open on October 1, are expected to provide care for 13.9 million people next year. This will also add to a 9.4 percent increase in private health insurance spending.
Chances are your organization is not yet completely prepared to deal with the amount of new consumers that will be applying for healthcare in the coming months. Managing such high volumes of new customers seeking affordable care, however, will be a key determining factor between success and failure with the changes that are set to come into place.
Here are some ways health insurance providers can prepare for the changes set for next year:
- Reduce call center wait time and increase customer service value: Nobody likes waiting on the phone for customer service. Wait time increases customer frustration and, in turn, churn rates. And anxious customers, some who may already have health issues, are going to have little patience for offices that cannot keep up with their needs. They will simply move on to another provider. Rather than hiring a whole new team of call center agents, however, it is often more affordable to outsource your program or even just your overflow to a team who can provide you with the resources that you need at a much lower cost.
- Let someone else manage eligibility determination: With all of the changes in healthcare, there is enough to get done over the course of each day in dealing with the demands of existing customers. There are now complex layers to consider when determining eligibility and the influx of new customers seeking coverage and customer service increases the volume of work for your teams exponentially. Instead, outsource the eligibility process to experts like Solix, who have been effectively and efficiently delivering eligibility screening and customer communications programs for well over a decade.
- Be prepared for program integrity audits before they happen: With concerns about waste, fraud and abuse already coming into play, the challenges insurers face ensuring, monitoring and maintaining program integrity is critical. Ensure your program has appropriate compliance safeguards in place from the start including ongoing monitoring and solid, audit-ready reporting. Programs such as Solix Connect incorporate these safeguards into the overall program to help clients and ensure they’re prepared.
If your organization wants to stay ahead of the game in 2014, the easiest solution is to consider outsourcing some or all of these basic business practices. By outsourcing you can enjoy benefits such as certified, well-trained resources to effectively represent your brand and put your customers’ needs first. You’ll also be able to ensure fast, accurate eligibility determination and confidence in your overall program integrity, especially where HIPAA and PCI compliance are critical. Your internal team will have the time they need to work on other business critical projects to help your organization remain competitive.