Ready or not, post enrollment is around the corner. Are you ready?

October 8, 2015 Ray Catudal

You probably haven’t had much time to think about post enrollment yet because you are wrapping things up for go live on open enrollment. But, you really do need to be thinking now about what happens after open enrollment is over because the next tsunami is already in the making.

You are working to bring new customers into the fold with open enrollment, that’s the goal isn’t it? Well then you need to be prepared to answer the wave of questions that come with new customers and new plan offerings. Studies show that consumers do not really know how to use their benefits or understand their plans. In addition to the blog post I wrote about this here a Harris poll shows that two out of five individuals do not understand their benefits. While people don’t need to be experts to purchase and retain coverage, they do need effective tools and resources at the appropriate times to make informed decisions so that they can maintain their coverage over time.

Call Center vs. Self-Service

Although some conduct significant research to choose the right health plan, and with some companies offering decision support tools to help, many people still don’t know what services their plan covers.

That leaves a lot of people that have questions. Are you prepared to answer those questions? Are you thinking of staffing a call center to answer the avalanche of questions that are coming or have you thought about implementing a self-service model so that members can answer their own questions?

Introducing a virtual assistant can substantially reduce live service rep calls (link CF case study) to answer questions like:

  • Can I get help with a personalized daily food plan?
  • Where can I get screened for depression?
  • How do I set up my HSA account?
  • When do I get approved?
  • I lost my card, where can I get a new one?
  • How do I add dental to my plan?
  • My income has changed can I get a subsidized plan?

Those are just a small sampling of questions that get asked daily. And, if the member isn’t calling you to ask these questions they are searching the web for the answers. It seems disconnected. Members need to go to multiple websites to get their questions answered, leaving the place where they are, and they end up getting caught with information overload from several different webpages.

Introduce a Healthcare Hub

Wouldn't it be great to have one place for people to not only get their questions answered, but to also have someone engage with them and nudge them along to manage their health? And for you, it allows you to mange the information the member is receiving and it maintains a relationship with them. There is such a place and it’s called a hub. Companies are currently battling to be the hub for consumers’ health. Google has become a place like that for general information and who knows they may go beyond that with the investment in Oscar health plan.

But, are you providing a health care hub for your members? Not only do you need a hub, but you need a mobile hub so that people can carry their hub around with them. Wherever the hub ultimately lives, a virtual assistant should be there guiding your members through the options of understanding their benefits, finding an in-network specialist, learning about the different prices for a procedure or managing their general health and wellness. This can all happen "in the moment" because virtual assistants can be activated with one touch, 24/7/365. No need to go to external sites, videos or education modules with a virtual assistant.

The good news is that it’s not too late – just start small and in an agile way. CodeBaby's Intelligent Virtual Assistants can be deployed in just a few weeks. Initially they can answer common questions that consumers have regarding their benefits. Later, the virtual coach can grow to become smarter and leverage cognitive technologies and artificial intelligence to answer verbal questions that consumers ask via a monitor or smartphone. If all members have to do is speak to their computer or smartphone, how can you still be thinking about head count in call centers?

So if you think about how many people are currently struggling with understanding their benefits, preventative medicine or an illness, you will quickly realize that there are not enough call centers, doctors and nurses in the world to support each person. This is in addition to all those millennials that prefer not to speak to a human anyway. Isn't it time that you put together your long-term health management strategy and make sure there’s an artificial intelligent component to it? Progressive companies understand that they need to differentiate themselves and create loyal clients by putting customer experience at the top of their agenda.

Thanks for reading. Why not check out more of our posts? Here are some to get you started:

About the Author

Ray Catudal

As Director of Healthcare Consulting, Ray is focused on CodeBaby’s healthcare specific customers and delivering on CodeBaby’s mission of customer centricity. With over 20 years of experience in medical devices, healthcare and technology, specifically: ehealth, health insurance, and software, Ray is a subject matter expert who contributes to industry articles, and speaks at trade shows and events.

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