Challenges
This Medium-Sized U.S. Healthcare Payer’s biggest challenge was incorporating their plan information into Centers of Medicare and Medicaid Services (CMS) approved Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents.
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, resulting in CMS errata penalties, a poor customer experience, and exposure to lawsuits.
As the healthcare payer added 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, requiring manual insertion of HTML tags into each of their ANOC/EOC PDFs.
Solution
To solve their problems, the payer enlisted the help of 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 of 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 productionready 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 ANOC/EOC PDFs by applying PDF tagging on the 6 master templates, saving the payer months of time.
End result
Working alongside Elixir and within the platform, the healthcare payer automated their member communications end-to-end. What previously took the payer weeks is 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 also trained and empowered our teams to manage this solution ourselves, while remaining available afterwards to provide great support.” Director, Marketing and Product
“Elixir listened to our problems, devised and implemented solutions, and also trained and empowered our teams to manage this solution ourselves.”
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 erratarelated penalties, saved money on postage fees, and improved customer and employee experience.
