CareMore Puts Members First with 75% More Efficient ANOC & EOC Workflows

CareMore, part of Anthem, Inc. is a Medicare healthcare company based in Cerritos, California that serves Medicare beneficiaries and patients in Arizona, California, Nevada, Ohio, Virginia, Memphis, Tennessee and now in Des Moines, Iowa.

Medicare is one of the the largest and fastest growing markets in the U.S. CareMore strives to offer members the widest possible scope of healthcare coverage, products and services.

Communications between CareMore and their members are mission critical, both to increase new enrollments and to keep existing members aware of changes in their coverage.

Optimizing the processes for generating regulated member marketing materials and correspondence are a key part of CareMore’s operational strategy in terms of profitability and compliance.

Each year the Centers for Medicare and Medicaid Services (CMS) release revised model templates for the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) and require insurers to update all versions used for their plans. With 45 plans, CareMore managed a total of 154 versions counting both English and Spanish for the ANOC and EOC. Like all health plans, CareMore needed complete control over the content and data to ensure compliance and found that creating each version from scratch every year using the Centers for Medicare and Medicaid Services-provided templates was the best method to guarantee the content’s accuracy.

Manual processes to review both data and language introduced enormous potential for error with costly consequences. CareMore had to proof every version in its entirety, including the table of contents. Versions containing even one minor update required a complete overhaul. CareMore compensated by adding layers of approval cycles to ensure that errors were discovered and corrected prior to printing. Due to a lack of centralized content, an error in one model multiplied across all the models using the same content and each model had to be individually corrected.

Read the highlights or :

Results

75% Reduction in Time – Repeatable Year After Year 

Tango eliminates manual processes and automates the workflow using one master template to generate all the required versions for CareMore’s ANOCs and EOCs. Content is no longer embedded in each version. Instead, Tango centralizes and manages content, allowing multiple versions to share identical language, data, and other assets. Automation lets CareMore place even more focus on improving member services.

4 Master Template Models Replaced 154 Versions

Two master templates generate all the ANOC versions – one for English and another for Spanish; another two generate the EOCs in the same languages

Reduced Approval Time by 50% 

Tango has eliminated numerous approval steps through automated and rules-based processes.

By :
Comments : Off