The Power of Collaboration and Configurability

 In The Power of Collaboration

At the onset of a global pandemic, Blue plans had to respond quickly, and NASCO was there to help them do it.

With very little lead time, the Blues were required to adapt their systems and processes to ensure care for millions of members across the nation.

Plans running on MembersEdge were able to quickly identify and leverage existing capabilities to meet specific requirements to meet these challenges head on.

NASCO’s Membership and Billing Portfolio Governance Council facilitated collaboration across plans and determined a configurable approach to meeting both legislative and plan-driven payment and customer A/R management rules that would meet the needs of all Blue plans collectively as their states requested supportive payer-driven payment concessions in this challenging financial crisis. NASCO assisted in testing and execution at each plan to ensure configuration solutions met each plan’s customer-driven needs and experiences.

Additionally, the state of New Jersey Department of Banking and Insurance (DOBI) expanded delinquency and payback options even further. NASCO collaborated with Horizon BCBSNJ and quickly conceptualized a 3-step configuration approach:

  1. Waiving delinquency for the population that fell into the timeframe where COVID-19 was impacting the ability for customers to pay amid uncertain financial times.
  2. Applying automated write offs to allow the plan to provide access to care to customers while creating premium deferrals for those customers on a prorated basis.
  3. Automatically calculating and generating the premium deferral amounts and invoice adjustments to provide a prorated premium payment plan to customers not in a position to pay their premium in the defined crisis period.

The concept of premium deferrals can quickly and consistently be deployed for any targeted customer base and invoice period that a Blue plan wishes to apply, allowing them to maneuver quicker and respond to situations in their respective markets.

Through its configurability, MembersEdge is also well positioned to support what plans are contemplating now as a ‘premium holidays’ for members who could not receive care during ‘shelter in place’.

To learn more, contact John Cicchino, Director, Product Governance.