CASE STUDY

Open Enrollment Document Processing

Outsourcing Open Enrollment Document Processing Saves a Major U.S. Health Insurance Company

How do health insurance companies handle the deluge of paperwork that comes in during open enrollment season? Outsourcing open enrollment document processing can help health insurance companies handle the increase in workload during open enrollment season while decreasing operating costs. Keep reading to learn how DATAMARK helps health insurance providers handle a sudden influx of health insurance paperwork.

Case Study - Contact Center Workforce Management

Background: Open Enrollment Document Processing Overwhelms Health Insurance Companies

In early 2022, total health insurance enrollment reached an all-time high of more than 35 million people according to the U.S Department of Health and Human Services through the Office of the Secretary for Planning and Evaluation (ASPE). Furthermore, Health Savings Accounts (HSAs) have become 400 percent more popular among customers in the last decade due to lower premiums. Additional documentation is expected to increase as customers enroll in this insurance option. With 35 million people sending in paperwork during open enrollment, health insurance companies need to have a plan in place to handle the deluge of documents coming their way.

What is Open Enrollment Season?

Open enrollment season is a time period when people can enroll in a health insurance plan for the next calendar year in the United States (healthcare.gov). It starts Nov. 1 of the current year and extends through Jan. 31 of the next year.

Most health insurance companies bolster their workloads to prepare for open enrollment season. The reason for this is mostly due to the increase in the number of documents that companies receive from customers. After receiving the documents, they have to properly capture, sort, process and store the data found in these documents. Most health insurance companies begin ramping up efforts to process the massive amount of received documents and related data as early as late December.

Challenge: Outsource Open Enrollment Document Processing

A Major U.S. Health Insurance Company decides to outsource open enrollment document processing to DATAMARK. Their hope is that DATAMARK brings their expertise in Enterprise Content Management (ECM) to properly process all its documentation, manage the data found within the paperwork and help business run more efficiently.

DATAMARK has been known as one of the nation’s leading experts in document processing and management. They partnered with major health insurance companies to provide this kind of service previously. DATAMARK assists healthcare providers in sorting, scanning, processing and digitally archiving a multitude of documents and other customer correspondence for easy retrieval. Through DATAMARK’s multi-channel capabilities, these documents come in through various intake channels like digital entries and physical documents.

Results: Analyze, Streamline, Automate and Expedite Document Processing

DATAMARK document processing experts propose a plan to implement a new document processing system. First, they must analyze the health insurance company’s current workflow. Next, they’ll identify opportunities for improvement. Implementing automation is one of the top suggestions on their mind as they put their proposal together.

How Can Automation Speed Up Aspects of Document Processing?

To process documents, DATAMARK uses various forms of automation. Automation is technology applied to business processes that would usually be performed manually. It is now one of the most convenient and efficient options when it comes to document processing. Leveraging robotics and other technology, it largely monitors and controls productivity for repetitive processes by removing the manual effort and streamlining the workflow.

Analyzing the Document Processing Workflow

The business engineering team documents the workflow using their Business Process Management System (BPMS). Lean Six Sigma and other methodologies are applied to identify and remove redundant steps. DATAMARK’s experts also work with the client to understand the pain points in the process.

First, DATAMARK’s skilled workforce receives additional training to handle the forecasted increase in open enrollment document processing for the health insurance provider. Next, they start by eliminating unnecessary processes and irrelevant procedural costs. After capturing critical information within the documents, DATAMARK employees route it to the appropriate department within the organization. This allows the health insurance providers to focus on providing their customers with high-quality coverage while improving their business.

Optical Character Recognition (OCR)

One form of automation technology is Optical Character Recognition (OCR). By selecting text from a specific area on a document, OCR can eliminate the tedious configuration of irrelevant text, which is not required from the document. OCR technology streamlines the sorting and analysis of textual data by eliminating manual steps. Consequently, OCR helps reduce both human error and operational costs.

In addition, companies can benefit from using OCR by leveraging the data to make predictions about changes in customer behavior and market trends. In one year alone, OCR helped DATAMARK handle 40 million pieces of mail and process more than 250 million documents for its clients, some of which are major health insurance providers with numerous members.

EHR & OCR: Electronic Health Records and Optical Character Recognition

Throughout much of the healthcare industry, including health insurance providers, electronic health records (EHR) is becoming the norm due to federal mandates. EHR helps centralize patient information, which otherwise would be dispersed across multiple documents or databases. EHR can help safeguard important information and data for both insurance companies and their members. During the open enrollment, this can either hinder or expedite important medical documentation. With the help of OCR technology, information transmitted from one location to another can be exchanged through EHR applications and leave little room for errors and complications. Billing information, patient medical history, and claims can be retrieved easily through the help of EHR and OCR technology.  DATAMARK has helped capture data required for EHR.

DATAMARK specializes in creating an enterprise content management, or ECM, solution, encompassing all of the strategies, methods, and tools used to manage all types of data found on documents that enter an organization. This can include but is not limited to high-volume scanning and imaging, automated data capture, and document management. An ECM system can be highly valuable to health insurance companies implementing the use of EHR and currently processing open enrollment documents. It ensures a secure approach to handling a large amount of complex data. Additionally, an ECM system can help insurance companies stay compliant with privacy and security regulations, including HIPAA.  

As applications, claims, and other forms of insurance documents accumulate, partnering with a document processing specialist can benefit the insurance company in many ways. Digitizing and automating several of the process methods may mitigate the overwhelming amount of workload. Partnering with a document processing specialist like DATAMARK can ease the stress open enrollment can cause health insurance companies.

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