What to Look for in Health Insurance Enrollment Technology
Health insurance enrollment technology requires certain features and capabilities to successfully enroll, retain, and manage beneficiaries.
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By - Health insurance enrollment technology is designed to offer payers convenience, cost savings, and administrative ease-of-mind when it comes managing beneficiaries enrolled in health plans.
Many Americans face challenges when seeking new health insurance, including finding an affordable plan compliant with the ACA, navigating the complexities of enrollment, and evaluating their best options for coverage.
An insurance enrollment platform for new and recurring beneficiaries can provide payers with the tools to address these challenges and improve the enrollment process from every angle.
In order to provide consumers and businesses an easier way to navigate the insurance market, enrollment technology needs to foster a streamlined user experience while including guidance systems and customization tools that allow payers to use these solutions for their most pressing enrollment concerns, according to a new KLAS report.
Enrollment experience is paramount
In the KLAS report, emailed to journalists, just over 50 percent of businesses using enrollment solutions found them to be highly or exceptionally impactful for improving enrollment for consumers.
The best technologies and software platforms are equipped with functions that automatically catch application errors, provide solid interfaces between quoting and enrollment modules, reduce the time it takes consumers to enroll, respondents said.
Businesses also look for interoperable technologies that assist, rather than inhibit, other technologies they are using.
Other ways to improve the enrollment experience include limiting the amount of paperwork needed, enhancing consumer transparency, and creating user-friendly interfaces through a marketplace portal for health plans. Digital marketplace portals and price-checking are important features to have for improving consumer experience.
High quality health insurance enrollment tools must adhere to two simple rules: keep it simple and keep it useful, KLAS says. Cluttering the user interface with clunky navigation and unnecessary features will only frustrate insurance customers and health plan employees.
Successful solutions will provide confident enrollment guidance
The most successful enrollment technology will help payers stay ahead of the game by building platforms that respond to ongoing changes within the healthcare industry.
Data from the KLAS report indicates that the majority of health plan employees and consumers found their enrollment guidance and industry foresight capabilities to be satisfactory. Some technologies, however, only specialize in certain markets and areas of industry compliance.
Some of the most appealing enrollment technologies guided users through the ACA marketplace and delivered timely updates on compliance rules. On the other hand, some platforms weren’t poised to scale with larger payers nor had the flexibility to support and grow smaller payers over time.
The best enrollment services will communicate changes in insurance policy at the state and federal level and provide regular updates to ensure compliance. Users that are effectively guided through changes in the industry can even fix general errors in overbilling and operational stability, according to the findings from KLAS.
Customization is key for success
The ability for users to customize their software to their unique business needs is a critical feature of enrollment technology. This can include building interoperable software and the use of data analytics to identify key concerns in operational workflows.
As organizations navigate these technologies, they must be able to immediately address a current problem while having the flexibility to add other modules or services. For example, health plan employees may pursue a technology solution that adequately addresses enrollment but may have enough success with it to add on a consumer billing service either through the software itself or an outside integration.
Health plan executives looking into enrollment technology should consider the value of their investment, and make sure that their spending is promoting a cost-effective multi-lateral solution to the barriers that come with managing member enrollment.
Most enrollment vendors don’t meet all of these criteria across the board, and the need for new and effective solutions is necessary due to the uncertainties in future federal insurance policy and a changing insurance market.
“While regulations and the ACA may change, systems for health insurance enrollment will always be needed. Currently, however, overall vendor performance in this market is well below what health plans need and expect, a reflection of the segment’s complexity,” the KLAS authors wrote.
“Vendors dedicated to the healthcare payer market, though critical, are relatively few in number, and in this market of constant change, health plans view vendor stability as a core need as much as actual capability.”
