HIMSSCast: Foundation of good data drives enrollment, claims payment and member satisfaction 

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Digital transformation in the payer industry means moving beyond the status quo. Insurance and the ways payers interact with members, especially new members in the enrollment process, are ripe for technology upgrades, according to Gary Davis, national practice leader for Noyo, a software company that unveiled an enrollment solution last year.

In all other areas of our lives, technology makes getting what we want pretty much instantaneous, Davis said. But in health insurance, it can take two weeks to bring a new member online.

"Enrollment drives the rest of the ecosystem," Davis said. 

Where does AI fit in?

"In order for AI to be at its best it has to start with a feed of good data," Davis said. 

Davis, who worked for an insurance company for 28 years, explains more in his conversation with Susan Morse, executive editor of Healthcare Finance News.

Talking points:

• Enrollment data drives the patient experience when they go to use their benefits.
• A Harris poll commissioned by Noyo found 48% of Americans who have employer coverage have frustration in using their benefits.
• About 40% experienced coverage delays, inability to access care and inaccurate bills, issues rooted in slow and inaccurate data flows.
• Over half of Americans rely on employer-sponsored insurance benefits.
• Two in five say they have been negatively impacted by errors with their benefits in some way, whether in the form of inaccurate bills (42%), access-to-care issues (41%) or coverage delays (37%).
   

More about this episode:

Claim denials and payer audits are affecting the revenue cycle

Million dollar claims increasing among employer plans

AI can improve the revenue cycle but increases risk, Moody's says

AI is effectuating the data analytics used to personalize care

How heightening patient engagement can reap financial rewards

Email the writer: SMorse@himss.org