Home Health Insurance A Payer-Provider Checklist for Better Customer Service

In a recent post, we considered how providing cost, context, and advice to insured members leads to a best-in-class healthcare cost transparency experience – and in the process, uncovered some common obstacles that make better member service seem like a significant challenge. Wondering where to start? If you are a payer or provider looking to improve member service, take a look at our short list of recommendations for better customer service:

€Make it easy for members to find a doctor
A majority of consumers find their general physician through family or friends, or by perusing independent review sites like Healthgrades.com and Yelp. According to a recent patient survey by SoftwareAdvice, these are the two most popular websites used by patients in their doctor search process – in spite of the fact that most payers and even many providers have a ‘find a doctor’ tool. This tool should be a major feature on the home page, not buried within links, or worse, after a login. Give users an easy-to-find, straightforward provider search tool on your public site home page that both shoppers and members can use.

Provide members with a checklist to prepare for doctor visits
Help improve efficiency by advising members what to do, what to bring, and what questions to ask before their appointment. For example, it is common practice for adult patients to fast prior to their annual physical appointment so that blood draws for lab tests can be performed. Providers we spoke with shared that at least half their patients forget to fast before this visit. Some providers make it a part of their practice to reach out to patients when scheduling and confirming appointments with a short pre-visit to-do list. Here is an opportunity for payers to step in and provide members with tools to make these visits more productive – with the added benefit of reducing time and unnecessary costs associated with re-scheduled appointments.

Reduce the amount of administrative work for providers (& payers)
I can hear providers cheering in the background now…. Jokes aside, payers should continue to explore ways to create process efficiencies that allow providers to spend more time providing care to patients and less time acting as an ad hoc benefits office. This might mean providing both members and providers a one-page guide to their Top 10 medical coverage benefits or a quick reference on member costs for copays and deductible balances. Further, payers can enhance provider portals with robust online search capabilities to easily find coverage details, forms and complete online form submissions.

Give providers accurate and up-to-date information
Providers regularly refer patients to specialists and other healthcare services. At times, these referrals lead to providers who no longer accept their patient’s insurance – a bad patient experience for all parties involved. This can be avoided if providers have a process in place when insurance coverage changes. It may be as simple as updating the provider site to show a current list of plans accepted. Payers can enhance their provider portals to make up-to-date information easily accessible by leveraging their current ‘find a doctor’ search tool used by members.

Encourage members to use their general practitioner
Thanks to a plethora of health-related sites such as WebMD, providers are seeing a huge uptick in patients self-diagnosing and making appointments directly with a specialist, bypassing their primary doctor. This sometimes results in costly specialist appointments that could have been avoided. Insurers can cultivate their online member portal as a trusted resource where members turn to learn more about a health issue – one where the principal call to action is scheduling an appointment with a primary doctor. Further, as providers develop more online health assets for their patients, they can guide patients to first meet with their primary doctor.

As short as this checklist is, some of these items are no easy task – current budgets notwithstanding. Payers and providers should challenge themselves to find some quick wins. Don’t be surprised when this list easily aligns with current company goals. Which of these items would you like to check off for 2014?

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