Customer
The customer is a large quality care provider. They offer health care in the New England area, primarily in New Hampshire. They offer an extensive network of over 1200 affiliated providers, providers on staff,thousands of independent physician and group practices and 45 hospitals.
 
Challenge
Consumer Driven Health Plans (CDHP) reduce health insurance costs while improving the overall health of employees. Employees take the role of educated health care consumers, a well-designed CDHP can rein in skyrocketing health insurance costs while providing employees with the appropriate level of quality health care they need. To facilitate CDHP implementation healthcare payers look forward to integration and enhancement of the existing systems in claims processing, Decision support and web based member enrollment and choice plans selection aids.

Solution
This portal enables the employer community to enroll their employee’s online, design benefits plan with respect to Annual deductibles, Co insurance amount and stop loss amount, to structure Health reimbursement and Health savings accounts. Enabled members, flexibility of care to pick and choose services and providers, Choice options to compare CDHP plan with other plans with respect to out of pocket expenses. The backend systems like Decision support, “Proact-employee enrollment system “and claims were also enhanced and integrated to support this portal.
 
Benefits
Reduction in Administrative Costs
Customer able to pick and choose
Reduction in sales effort

Decrease in Medical Costs
Cost Conscious Patients with complete awareness on plan and benefits
Decrease in Physician office Visit

Increase in Productivity
Process time taken into account for semi automated and automated process measured at 3, 6 and 9 months averaged out to 30% for sales & marketing, enrollment and benefits administration collectively.

Increase in Customer satisfaction
Quote Info time reduced from 3 days to 1 day
Customer was able to choose provider, see all benefit information and take conscious decision