A Health Plan Moment of Truth occurs any time an employee interacts with your health plan. The concept was adapted from Shep Hyken’s Moments of Truth Framework in his book, Amaze Every Customer Every Time. Hyken was the keynote speaker at the 2017 Health Activation Conference.
Two weeks ago we discussed how Health Plan Moments of Truth relate to this important concept: To solve the healthcare cost problem, we have to solve the healthcare experience problem first.
This is Part Two of our blog series, Best Practices for Creating Health Plan Moments of Magic. Be sure and check out Part One.
Moment of Truth No. 3: Addressing Issues with the Insurance Company
Explanation of Benefits (EOB) statements are long and confusing documents that often include billing errors. It’s not surprising that employees find these statements overwhelming and have to make repeated calls to insurance providers during work hours to better understand them.
In addition, there is the hassle of getting pre-authorization for procedures and medications. Healthcare navigation solutions like Compass can simplify healthcare for employees and facilitate the pre-authorization process. Here are some other strategies for making it easier to address insurance company issues:
- OFFER ALTERNATIVES: “If we have to return an unfavorable answer, I always try to offer possible solutions, even if it means additional research on my end.”- Financial Services Company
- DO YOUR HOMEWORK: “Before meeting in person or returning a call, collect information on that person (such as what department, length of service, etc.) to assure the person how important he/she to me, and I have information to assist them.” – North Texas City
- BE RESPONSIVE: “Always return benefits error calls on the same day (even if on the evenings or weekends) to acknowledge we’ve received them.”– Oil & Gas Company
- GO THE EXTRA MILE: “Take additional time to explain our high-deductible plan to our high-risk population so they can experience the plan with the lowest out-of-pocket cost.” – Oil & Gas Company
Moment of Truth No. 4: Open Enrollment
Open Enrollment is a major source of confusion for employees. Unsure of how to compare different health insurance plans, employees often turn to their peers, as often as they turn to the human resource department, for answers.
As they register for their plans, employees may not understand what an embedded deductible is or how individual and family deductibles work. What are some steps you can take to make even Open Enrollment a magical experience?
- MAKE IT SIMPLE: “We provide individual cost analysis to help employees choose the correct plans during Open Enrollment and at different life events.” – North Texas Engineering Company
- BE ACCESSIBLE: “We arranged webinars and in-person meetings to talk to employees about our programs and answer their questions. It lets employees know we’re there for them.” – Manufacturing Company
- GO THE EXTRA MILE: “During Open Enrollment, we switched carriers and I personally I stayed late every day to call employees and confirm their plan choices.” – North Texas Healthcare Company
- OFFER HEALTHCARE NAVIGATION SERVICES: “We hired Compass and refer employees to them for Open Enrollment questions, benefit questions, etc.” – North Texas Law Firm
Moment of Truth No. 5: Receiving a Diagnosis
Understandably, one of the most stressful and emotional times for employees and their families is when they receive a serious diagnosis. They are often in an emotional fog and are unsure of the next steps to take. Also, time is usually of the essence – and they need a quick, reliable resource to help them find the care they need.
It’s important to remind your employees there are resources who have experience dealing with these kinds of circumstances and can help them through these difficult times. Here are some other suggestions from your peers:
- PROVIDE ANSWERS: “We’ve implemented a second opinion service for serious diagnoses to give comfort to people in difficult situations.” – Investment Management Company
- OFFER HEALTHCARE NAVIGATION SERVICES: “An employee’s daughter needed jaw surgery. Compass found an in-network surgeon & coordinated with insurance and provider to have procedure pre-approved.” – Hospitality Company
- PROVIDE PEACE OF MIND: “It was a huge relief to have a high quality/screened caregiver for our daughter to get care while out-of-state at college.” – Telecommunications Company
- BE COMPASSIONATE: “Listen to an employee whose family is going through a tough time to show concern.” – Oil & Gas Company
There are many more opportunities to turn Health Plan Moments of Truth into Moments of Magic and elevate your employees’ health benefits experience.
To learn more about how to empower your employees with healthcare navigation services, register for our webinars.
Moments of Magic® is a registered trademark of Shep Hyken. Used with permission.
- Blog: Why Focusing on the Healthcare Experience is Critical to Solving the Employer Healthcare Cost Problem
- Blog: Best Practices for Creating Health Plan Moments of Magic (Part One)
- eBook: 10 Strategies to Amaze Every Employee, Every Time
- Cheat Sheet: 16 Health Plan Moments of Truth
- Webinar: Best Practices for Creating Health Plan Moments of Magic