Better Health Insurance Data Quality - Electronic Data Interchange

Better Data Quality Is Better Business for Health Insurer

Did you know that 59 percent of employers are using a third-party technology platform for benefits enrollment?* That means, as a health insurer, more than half of your group business is sending you a file that doesn't enforce the same business rules as your membership system. And as your book of business grows, so does the volume of files to process.

That's where leading health insurer Regence, a part of Cambia Health Solutions family of companies, found itself in 2013. With growth came the unprecedented volume of files to process into its membership system. Once the staff loaded the files from their groups' various enrollment systems, it had to query for any errors. Any resulting errors – which averaged 5,000 per month – were sent to the membership team to manually update. The staff was already overwhelmed, and the number of groups and files were only growing. 

Adding overhead to a process that was already time-consuming would mean additional expense on top of the already high risk of error. So Regence set out to find an alternative solution, one that would translate third-party enrollment data and enforce its business rules, so any files received would be ready to load into its membership system. 

And that's exactly what Regence found with Benefitfocus eExchange. Not only did Regence reduce overhead expense, it also experienced greater efficiency with a 70 percent decrease in monthly processing volume. 

“Not having to invest in additional infrastructure to manage higher volume helped us realize tremendous savings,” stated Tom Allred, enrollment automation support at Regence. 

Download the full success story learn more about the positive business results Regence achieved by using this data exchange service.


*LIMRA Survey: Convenient and Connected: How Are Employers Using Technology Today?