Open Enrollment: Details
Open enrollment season is the only time that employees can sign up as new clients or simply renew their benefits plans with the companies they work for (barring certain circumstances such as a new job, marriage, birth, adoption, or divorce). Despite the fact that the benefits enrollment process occurs every year at the same time, many people simply let their insurance choices carry over from year to year without reviewing their options, wait for the last minute to try and enroll and make changes in the 11th hour, or else miss the deadline for enrollment altogether.
Employee engagement around open enrollment is something that can and should be actively maintained and encouraged throughout the year by both a business and carrier so that open enrollment is just one part of your employees’ experience around their overall health and wellness. It’s so important to maintain high levels of engagement because your open enrollment process is just the beginning of an ongoing health management process where your employees partner with their health plan to fully use their benefits to improve outcomes and lower costs. The open enrollment process is also just the beginning of an ongoing healthcare management process that includes all your employees, especially when it comes to maintenance and preventative care.
Primary Care Physician (PCP) Selection
Some people forgo choosing a Primary Care Physician (PCP) completely. In fact, every year the number of people who have chosen a PCP has decreased, including people in their 60s.1 While the reasoning behind the decrease can be appreciated, namely healthy customers perceive they don’t really need to go in to see the doctor, it is also not the best decision for their long term health nor optimized for cost savings; a substantial proportion of medical costs are for preventable conditions.
Having even one visit with a PCP is a best practice because it establishes a relationship and sets a foundation for future visits; whether for preventative care or because of illness.
Tower Insurance case study
To discover how Ushur deepens customer relationships with digital-enabled engagement for insurance companies, get your copy of this Tower Insurance case study.Get your copy
And studies show that patient satisfaction increases when patients have chosen a PCP to work with,2 whether they visit the doctor regularly or not.
Unfortunately, most technology solutions offered by benefits packages makes choosing a PCP difficult and time consuming rather than a time savings. Instead of recognizing a member’s location and physician care needs, and then delivering relevant results, choices are listed in pages and pages of physician choices and offer no way to know which one provides the best care for a member’s specific requirements. If a member does decide to check a physician rating system, it’s another manual process in which they must leave the insurance provider’s site, inadvertently leading individuals to a PCP or specialist that is out of network and therefore more costly.
The best way to prevent this very expensive and unexpected error is to make sure that customers can easily access their network provider list whether they are at home, or on the go, perhaps even in a doctor’s office, about to schedule a procedure. And make it easy for the employee to see and understand the difference in cost if they choose to go out-of-network for care.
Currently, searching for network care is cumbersome and vague and offers few guarantees of coverage accuracy. Additionally, if there are differing levels of benefits offered, as is the case for many HR departments in many organizations, the employee has to know which plan they have in order to know which network of caregivers they can use. This unwieldy experience leads to costly employee billing surprises, dissatisfied clients, and time-consuming health plan call center operational costs. Customer frustration quickly rises as their employees have to waste time on a call for something that they should be able to quickly locate with their smartphones. For a small business especially, those benefits administration frustrations can erupt into a nightmare for the HR team
Ushur Customer Experience Automation™ Enables Decision Making
Ushur’s proprietary automation technology, Invisible App™, uses artificial intelligence (AI) and machine learning (ML) to create a personalized experience for each employee regardless of the communication channel. Drawing from their own information and the plan that they have chosen, Ushur’s UX-first technology platform allows employees to search for PCPs, facilities, and services, quickly and easily. Employees only revert to querying the health plan call center for more unique, complex inquiries. And even then, with the AI-driven Invisible App™, repeated queries on the same topic can be identified and addressed via intelligent automation and proactive employee communication. Altogether, the end goal of this automation lifecycle is to decrease health plan call center volume in order to drive cost savings and increase accuracy.
By drawing on each employee’s personal benefit information, members can ensure that their care provider choices remain in-network, with verified quality and lower cost. They can easily choose their PCP and even make an initial appointment. Using Ushur’s cloud-native Invisible App™ to make the research process easy and simple encourages employees to take full advantage of their benefits.