Mid-size Health Insurer Automates 508-Compliant ANOCs & EOCs

Elixir
2 min read
Nov 9, 2024 1:58:00 PM

Overview

A medium-sized U.S. Healthcare Payer was facing a challenge. They needed to incorporate plan information into Centers of Medicare and Medicaid Services (CMS), approved Annual Notice of Change (ANOC), and Evidence of Coverage (EOC) documents.

Problem

Each year, the payer had to create and manage hundreds of individual ANOC/EOC versions from scratch. The creation of these versions took so long that the payer could not implement a proper review process. This resulted in CMS errata penalties, poor customer experience, and exposure to lawsuits.

As they additional plans and offerings, the amount of work to create their ANOC/EOC documents increased exponentially. In addition to this work, once the documents were created, the payer had to make them accessible and 508 compliant. This required the manual insertion of HTML tags into each of the ANOC/EOC PDFs.

Solution

The payer worked with Elixir® to streamline and automate the creation and maintenance of their Medicare communications.

The first step was to automate the insertion of the payer’s CMS approved data onto the Elixir® platform. Elixir then consolidated all the payer’s plan versions into 6 Elixir master templates, one for each of their respective CMS models.

Elixir’s MS Word plug-in allows the payer’s team to centrally manage and update the model language, generate live production ready proofs of their updated changes, and produce the documents with minimal training. Automations were added to improve the approvals and QA process. Finally, a yearly change-tracking process was introduced, which the payer uses to manage their yearly ANOC/EOC updates themselves.

Elixir also automated the 508 accessibility of the PDFs by applying PDF tagging on the 6 master templates, saving the payer months of time.

Outcome

Working alongside Elixir, and within the platform, the healthcare payer automated their member communications end-to-end. What previously took the payer weeks is now accomplished in minutes. To update their ANOC/EOC documents, the payer merely uploads/updates the new content and business rule documents into Elixir.

Once approved internally, Elixir directly ingests their CMS-approved data and instantly produces their ANOC/EOC documents in print, large print, and accessible – 508 compliant – electronic formats.

“Unlike other vendors, the Elixir team provided end-to-end service. They listened to our problems, devised and implemented solutions, and trained our teams to manage this solution ourselves, while remaining available afterwards to provide great support.” - Director, Marketing and Product

After Elixir generates the documents, the payer combines the ANOC/EOCs with other documents to be mailed as part of a yearly kit. Elixir helps the healthcare payer by assembling the package and all its materials. This process is applied globally across all their plans.

Since automating their ANOC/EOC documents on Elixir, the payer had zero errata related penalties, saved money on postage fees, and improved customer and employee experience.

Would you like to see how Elixir can help you improve your customer communications? Schedule a demo.