Customer Journey BlueCross BlueShield of Tennessee BCBST PRESENTERS - - PowerPoint PPT Presentation

Customer Journey

BlueCross BlueShield of Tennessee

BCBST PRESENTERS

ASHLEIGH JENKINS RN, BSN, LSSBB

Director, Clinical & Communication Services Ashleigh has over 14 years of experience in both the insurance and healthcare industry. A registered nurse, by trade, Ashleigh has tremendous experience and insight as it relates to the clinical impact of healthcare activities. She currently leads the areas responsible for both Clinical System configuration, supporting the Utilization and Care Management activities for over 4 million member lives; as well as Enterprise Communication Configuration related to provider and member communications..

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MANDY HETRICK

Team Lead, Forms Transformation Mandy has over 16 years of experience within the health insurance industry. Throughout her career at Blue Cross Blue Shield of Tennessee, she has served in the capacity of the Inter Plan Liaison and Inter Plan Supervisor, handling communication efforts with partner Blue Plans . Mandy currently serves as the Team Lead over the Forms Transformation area and aids in the efforts to transform customer communication delivery at an Enterprise level.

Fast facts about

BlueCross BlueShield of Tennessee

• Not-for-profit company established more than 70 years ago
• Serving 3.4 million members and 11,000 companies
• Paying 85 million claims per year
• Partnering with 20,000+ health care providers
• Giving $14 million each year in charitable investments
• Employing 5,800 professionals to fulfill this mission:

Peace of Mind through Better Health

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Peace of Mind through Better Health

Our strengths

Large and Small group accounts as well as individual book of business In the state Medicaid business for over 20 years, successfully managing both full risk and ASO accounts for Medicaid, DIDD, and Long Term Support Service members (LTSS) Medicare Advantage products

• ffer Peace of Mind to members
• ver 65

Support for Shared Health, wholly owned subsidiary handling multi-state Medicaid business models

MEDICARE SUPPLEMENT SHARED HEALTH COMMERCIAL- GROUPS AND ASO ACCOUNTS MEDICAID/LTSS

PROBLEM

What were we looking for? In 2014 our company began searching for an enterprise forms management system that would allow flexibility and the ability to streamline our current document creation processes. There were several driving factors that were influencing our search:

• Current Letter System utilized on the Claims Payment system was out of support
• Letter System utilized on the Care Management system did not provide the long

term functionality that we knew we would need moving forward and to be more competitive in the Healthcare space

• Inability to contain cost through document standardization
• Inability to automate multiple approval workflows driven by multi-business

support

• Inability to track all of our member and provider communications in one system

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CCM VENDOR SELECTION CONSIDERATIONS

Opportunities for Advancement & Innovation

Decrease in Overall templates

Available Medium

(Print, Web, Text) Future Growth Configuration Logic Partner

Workflow

Industry Leader

Audit Trail TN 6

WHY GMC?

Standardization

Omni-Channel

Enterprise Growth Shared Content

Partner

Approval Workflow

Industry Leader

Tracking 7

GMC INITIAL IMPLEMENTATION MILESTONES

NOVEMBER 2015

Vendor Selection

JANUARY 2016

Project Kickoff

FEBRUARY 2017

Phase I Completion- Integration with claims payment system complete, Retirement of legacy letter system

AUGUST 2017

Phase II Completion- Integration with Clinical Care Management System Complete, Retirement of legacy denial letter system

MARCH 2017

Phase II Kickoff

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Implementation Considerations

Data Model Master Template Layout Multi Line of Business Support Multiple Approval Pathways

Rationalization

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Review of every document to identify commonality and establish consistency in brand as well as language

Development

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Establishing data models and building documents

Transformation

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Standardization across documents means cost containment for printing/mailing letters, as well as Brand Compliance

GMC INITIAL IMPLEMENTATION MILESTONES

NOVEMBER 2015

Vendor Selection

JANUARY 2016

Project Kickoff

FEBRUARY 2017

Phase I Completion- Integration with claims payment system complete, Retirement of legacy letter system

JULY 2017

Phase II Completion- Integration with Clinical Care Management System Complete, Retirement of legacy denial letter system

MARCH 2017

Phase II Kickoff/Partnership with Brand Voice Initiative

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Transformation

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Results

• Cost savings related to standard envelopes, removing

the need to order over 50 custom envelopes

• Reported 3 FTE savings in one unit switching letters

to GMC Inspire off of another letter platform

• Enterprise visibility into member and provider

communications, allowing all of the different member/provider touchpoints to be aligned when speaking to customers

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GMC FUTURE PLANS

MARCH 2018

Full Implementation of Clinical Platform- Migration of 1500+ templates to Inspire Suite

SEPTEMBER 2017

Project Kickoff- Contact Preference Integration Other Initiatives-

• Over 40 applications in the backlog

to migrate to GMC Inspire

• Healthy Pregnancy Program
• EOB Transformation
• Member Welcome Kits
• Federal Business Migration from

Mainframe

• Integration with Appeals, Member

Outreach Systems

• Migrate Campaigns to Designer

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• Prioritize initiatives to ensure Corporate Priorities are set
• Evaluate resources
• Combined focus with restructuring documents with Customer Experience in

mind

• Enterprise “Top Ten” Initiative for both 2017 & 2018

GOVERNANCE STRUCTURE

Our strategy

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• Leverage the full system capabilities to expand beyond transactional

documents

– Incorporate document configuration in omni-channel – Leverage contract preferences – Evaluate ability to replace other content design tools

• Phased approach to transition additional external communications

to the GMC Inspire platform

FUTURE PLANS

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QUESTIONS ANSWERS

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BLUECROSS BLUESHIELD OF TN

Ashleigh Jenkins

Director, Clinical & Communication Services ashleigh_jenkins@bcbst.com

Mandy Hetrick

Team Lead, Forms Transformation Mandy_Hetrick@bcbst.com

BlueCross BlueShield of TN

1 Cameron Hill Circle Chattanooga, TN 37402

Contact Information

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