Automating a manual process to help reduce risk and errors

Successfully implementing automation by increments

Anyone who has administered highly-regulated documents understands that managing complexity comes before the arrival of clarity. They also know achieving that clarity is not easy.

Year One of our multi-year process with this MCO client began with a thorough assessment of the existing processes to determine the best way to deploy our Document Automation Tool for their SOBs and EOCs.

Both client staff turn over and resource shortages during implementation impacted the project year one, as the client came to realize that utilizing the tool was not a replacement for the engagement and knowledge needed on the client side. Luckily both the client and RRD saw the value to stick with it and allowed the RRD team to conduct a “lessons learned” after the first season ended and share best practices that would optimize the program.

By Year Two, the client saw improvements in turnaround times, document control and error reductions. As other internal teams saw the success of SOB and EOC programs, our work expanded into their ANOC versioning, as well as other critical compliance areas.

The client’s marketing, product and regulatory teams continued to reduce error rates and increase document compliance metrics. Their Benefit Knowledge experts were finally freed from repetitive document editing and formatting tasks, allowing them to focus on content quality and accuracy.

Document Versioning Made Easy

Reusable content blocks are stored in a central database and linked across multiple documents

Doc Version A
Doc Version B
Doc Version C

Many members. Many versions. Many needs. And one tool for all of them.

Growing member populations cause a growing problem

As of January 2012, there were more Americans over the age of 65 than at any other time in U.S. history.1 Today, 20% of the country’s population is over 65 and eligible for Medicare2, the government sponsored health program overseen by the Centers for Medicare and Medicaid Services (CMS). This case study focuses on a leading Managed Care Organization (MCO) as they searched for solutions that would help them more efficiently produce mail and manage CMS regulated materials to keep their members informed about the latest plan updates.

Because this MCO offers different Medicare plans in different states, they were required to mail multiple versions of lengthy documents, including some that exceeded 200 pages. For many MCOs, versioning these documents is a time-consuming, labor-intensive manual task, often resulting in errors. Combined with traditionally tight turnaround windows for CMS approvals and in-home dates, this is typically a chaotic process for many MCOs where time, money and transparency all but disappear.

To keep from falling victim to these circumstances again, our MCO client had developed two home grown programs for versioning their Medicare documents: one for Summary of Benefits (SOBs) and Evidence of Coverage (EOC) materials, the other for their Annual Notice of Changes (ANOCs). Several years into these programs, the client’s Marketing Department was still challenged with reducing errors, meeting deadlines and avoiding possible CMS fines. As a result, the decision was made to expand the company’s existing relationship with RRD Healthcare Solutions.

Many members

Versions accomplished

By fully integrating our Document Automation Tool into their operations, our MCO client successfully eliminated extensive manual processes that had plagued their Medicare materials production for years. Reduced cycle times, consistent content, improved accuracy, and streamlined processes for alternative formats led to production of in-language, large print, and 508 compliant versions of SOBs, EOCs and ANOCs.

Doc Type 2016 Standard Eng Version Large Print* 508 Translated
*Generated on Demand

The client now has the time to manage documents for multiple project lines, has better control over document changes, and enjoys day and night access to online tools. The solution has become an integral part of their overall workflow; and RRD Healthcare Solutions now helps them navigate all facets of their production process – from document composition, to compliance, to final USPS delivery.

Alternate versions as part of your workflow

MCOs must provide their members with alternative format document versions, including large print, translated versions (in any language spoken by more than 5% of member populations), and 508 Accessible versions for the visually impaired.

With our Document Automation Tool, alternate versions are now an integral part of workflow. Once English language content versions are complete, our Language Solutions translates content into the target language. Content is then imported back into the Document Automation Tool, where translated versions are dynamically generated and leverage design, style and branding elements from the English version.

This ability to reflow translated text in the application is especially useful in complex documents such as EOCs and ANOCs. Our foreign language character sets include Spanish, Chinese, Korean, Vietnamese, Hmong, Tagalong, Navajo and Russian, and we use the same process for both large print and 508 Accessible documents. Once content is created, tagged and loaded into our system, images, tables, lists and acronyms are given special consideration to allow usability by visually impaired members. Completed 508 versions are then audited via Adobe Professional Accessibility Report and reviewed with JAWS for the visually impaired.

Completing alternate versions as part of your workflow, rather than after documents are completed, dramatically reduces turnaround times and risks of variance between versions across all formats.

  1. “65 and Older Population Soars” U.S. News and World Reports, January 9, 2012
  2. U.S. Census Bureau

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