One of the largest healthcare insurance providers in the US streamlines member outbound communications with EDM

One of the largest healthcare insurance providers in the US streamlines member outbound communications with EDM

The client, a well-recognized healthcare insurance company with major operations centers in the southeast United States, serves nearly 4 million members. Its outbound communications consisted of a multitude of documents—explanation of benefits; invoices and statements; welcome kits, books and booklets; checks; inserts and marketing documents; and postcards—and the company began a search for a vendor partner to handle its printed and mailed materials.

Challenge

The resources and cost of printing and mailing enrollment materials, member communications, invoices and checks to over 3 million members had become costly and ineffective. After years of internalizing its printing and mailing function, a large US healthcare insurance provider initiated a comprehensive search for a business partner to alleviate the following pain points:

  • Costly, manual processes to support individual plans
  • Late mailings that left members and providers dissatisfied Ineffective in-house operations and resulting PHI errors
  • Full USPS postage rates and consistently escalating costs Personnel management and overtime costs during peak periods

Solution

EDM collaborated with the client to develop a 6-month strategy for migrating existing in-house operations to EDM’s facility. EDM’s in-house IT resources led the bulk of the project management, transition and redesign, allowing the client to stay focused on existing projects.

The transition was achieved without downtime or missed SLAs, giving the client’s executive leadership and operations team members peace of mind. Process efficiencies and cost savings were realized almost immediately.

The EDM solution relieved the threefold burden of managing the People, securing the Processes and keeping up with the ever-evolving Technology to maintain best-in-class outbound customer communications.

Results

Financial:

  • Total outbound communication expenditures reduced by 50%
  • Postal discounts maximized; costs decreased by 30%
  • Call volume was reduced in peak periods
  • Overtime costs decreased

Operational:

  • On-time delivery rate increased to 99.9% following an evaluation and redesign of process flow
  • Management dashboard included postal tracking and job data to enable real-time, day-to-day visibility
  • PHI errors reduced through use of an automated document factory with file-base reconciliation and integrated QC
  • Cross-unit standards created and consistent messaging was developed to enable multiple business units to coordinate effective mailings
  • Thorough mail piece review and Automated Enrollment Fulfillment process generated higher customer response rates

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Key Performance Indicators

50%

reduction in total outbound communications expenditures

30%

reduction in postage costs

99%

on-time delivery rate (due to evaluation and re-design of previous process flow)