Priority Health
Insurer speeds app development by 77% and automates 90+ business processes and 100% of member onboarding.
The challenge
Priority Health, a Michigan-based health insurer, struggled with manual, paper-based processes and a clunky database. Staff members in the Sales and Group Administration departments spent more time dealing with paperwork than selling plans and onboarding groups.
The health insurer needed better processes. After achieving success with the OnBase enterprise information platform in other departments, Priority Health realized it already had the answer.
The solution
An OnBase customer since 2002, Priority Health decided to expand its implementation of the enterprise content management solution. OnBase now manages the complete life cycle of Priority Health’s group onboarding and revenue cycle processes, automating predictable steps while empowering staff members to complete knowledge-driven work. By integrating OnBase with Priority Health’s enterprise core administration platform, Cognizant Facets®, the insurer provides its staff with a 360-degree view of member information.
Increases communication and collaboration
To renew a group membership, staff members create an e-form in OnBase. Once the staff member enters the customer’s group number, OnBase automatically populates the form with information from the member’s record in Facets, eliminating manual data entry to save time and reduce the risk of human error. Native business processing tools automatically notify staff members when the form enters their queue, even pulling a Commission ID from Facets and updating records in both systems with any new information, before sending the completed form to the Group Administration team.
Ensures compliance
In such a highly regulated environment, it is critical to comply with industry standards and government requirements. OnBase allows Priority Health to not only speed the group onboarding and revenue cycle processes, but also ensures information is accurate, catching and correcting any errors during, not after, processing. Before OnBase, staff completed daily production forms and attached all of the associated paperwork. Now, OnBase automatically checks for accuracy as the e-form travels through five different life cycles, sending a duplicate of the form to the quality team. If an error is discovered, staff quickly extract the documents from the process, make the needed corrections and return them to the process for completion.
Streamlining the revenue cycle process allows our sales reps to focus more on selling and less on administrative tasks, creating a competitive advantage for Priority Health.
— Bill Selles, Director of Workforce Management, Priority Health
The difference
Provides employees with a complete view of all work: “The ability to see where work is in the group onboarding process gives sales and revenue cycle leadership transparency and the ability to course-correct or fast-track work when necessary,” says Bill Selles, director, Workforce Management at Priority Health. Users across various departments manage cases and knowledge work with access to all data, documents and processes. Regardless of what stage the enrollment packet sits, employees have a full view of the completed work and are notified when a document is ready for their approval.
Empowers better, faster service: “Process automation from OnBase allows Priority Health to take business closer to group effective dates with confidence that we can still have an ID card on time for our members,” says Selles. With increased speed, accuracy and ease of processes, Priority Health enrolls members more quickly and accurately, elevating the customer service experience. Each department tracks its inventory and turnaround times via OnBase reports. This metric is essential to Priority Health’s leadership, allowing them to gauge department productivity and identify potential bottlenecks.
Improves audits: Relying on manual and paper-based processes results in important documentation stored in separate areas across an organization, making it difficult to comply with regulations or find errors and stay within service level agreement timelines. With OnBase, employees fix errors in real time. Additionally, OnBase stores all information electronically, with a fully transparent, auditable trail, making performing audits a much easier process.