Collaborative communication is essential for getting work done for any busy organization. At a time of exponentially increased healthcare demand, it’s imperative for healthcare payer organizations to facilitate fast and secure collaboration. The right tools are critical for interdependent teams like claims, benefits, enrollment, and others to stay connected and support business operations. In this post, we’ll explore how a comprehensive set of tools enable healthcare payers to provide better member experiences as well as improved relationships with partners.
The best collaborative communication tools for healthcare payer organizations
There are many software products on the market that bill themselves as collaboration tools. However, that doesn’t mean that they allow for collaborative communications.
A modern, cloud communications platform, on the other hand, does. A well-designed communications platform is an integrated suite of collaboration tools, including messaging, video, and phone solutions. It allows healthcare payer organizations to easily share information with members, providers, and other strategic outsourced partners.
There are a number of reasons healthcare payer organizations need better collaborative communication tools:
- They make it easier to exchange information
- They make it easier to share information securely
- They facilitate better healthcare outcomes for members
- They allow healthcare payers to create innovative, valuable programs
- They create a personalized experience for members
- They save money and support flexible workforce structures
- They play a role in making the payer-provider-member relationship less adversarial
Cloud communications platforms make it easier to exchange information
One of the biggest benefits of cloud communications platforms is that they make collaborative communication easier. Because these communications platforms support a number of communication modalities, partners and members have the flexibility to connect with payer organizations in their preferred manner.
Communicating with payer organizations can be challenging for partners and members. A 2017 survey revealed that while 60% of payers preferred to use online portals as their primary means of communicating with providers, only 39% of practice-based providers and 40% of facility-based providers wanted to communicate with payers in that way. RingCentral’s healthcare communications platform enables providers and members to reach out to payers both when and how they want to, thanks to messaging, video, phone, secure chat, voice, and contact center capabilities.
HITRUST CSF certified communications make it easier to share information securely
The healthcare industry is bound by stringent privacy legislation that makes secure information sharing crucial. Yet, when payers cannot effectively exchange information, or have all of the information they need, they may make decisions about payments that don’t benefit the patient or provider. Government research shows that payers have sometimes delayed payments, micromanaged care, rationed care, litigated, and engaged in brinkmanship.
With a HITRUST CSF certified cloud communications platform, providers can share information securely with payers so that payers understand the patient’s needs. A HITRUST CSF certified cloud communication platform meets HIPAA security standards to ensure that information is protected from end to end. The ability to transmit information safely enables providers to share patients’ information with payers, so payers can better understand why a treatment is necessary.
Cloud communications platforms facilitate better healthcare outcomes for members
When payers, providers, and outsourced BPO partners work together, members have better healthcare outcomes.
In the past several years, there have been some innovative projects in which payers and providers have worked with members to improve their healthcare outcomes. A project in Minnesota between a healthcare facility and an accountable care organization reduced hospital admissions by 16% and emergency department visits by 35%. One of the driving forces behind this collaboration was technology that easily allowed providers and the payer to share information with each other.
Cloud communications platforms help payers create innovative, valuable programs
Another way in which payers can benefit from implementing cloud communications is by creating valuable, innovative programs that help members and providers.
An example of one program is that payers could send automated notifications to their members to promote the need for immunizations during flu season. Immunizations play an important role in reducing doctor’s visits as well as more serious medical needs (such as emergency department visits and hospitalizations). Cloud communications platforms enable payers to manage these types of programs and encourage healthy lifestyles for their members.
Cloud communications platforms create a seamless experience
The relationship between members of health plans and payers can often be fraught. As mentioned earlier, payers have a history of denying patients’ claims or not paying them in full, fostering distrust and dislike. However, cloud communications could help change that relationship.
Cloud communications platforms include contact center capabilities. With these capabilities, payers can create a single point of contact in the billing department so members can connect with one person who handles their case (rather than being shunted from one customer service representative to another). Members feel as though they’re not just another number to the payer, which improves their relationship with the organization.
Cloud communications platforms can save money
In the US, private health plans alone spend $158 billion annually; administrative costs per month average 17.8%. Much of these administrative costs are due to manual processes, especially when it comes to claims approval.
Cloud communications platforms can help lower costs for payers by streamlining authorization processes. By utilizing direct routing rules for benefit authorization calls, network providers can more efficiently reach utilization review teams to authorize treatments and save time and money.
Cloud communications create better relationships between payers, partners, and members
The relationship between payers, partners, and members of health plans has long been adversarial: payers are painted as the bad guys for refusing to fund treatment that providers believe is essential for patients. A lack of transparency contributes to the negative view patients and providers hold of payers.
Cloud-based collaboration tools help deliver timely information and increase transparency by making it easier to share information between payers, providers, and members. They facilitate collaborative communication so information sharing can take place and better decisions can be made.
RingCentral’s cloud communications platform: boosting collaborative communication for payers
RingCentral’s cloud communications and contact center technologies enable secure and simple collaborative communication between payers, providers, and members, leading to better outcomes for all. See how cloud communications can transform your payer organization. Request a demo.
Originally published Feb 02, 2021, updated Apr 23, 2021