Improve enrollment efficiency for managed LTSS (Managed Long Term Care) health plan

 

Delivery Setting
Health Plan

 

Customer Profile

A managed long-term care community-based health plan (managed long-term services and supports)

Business Problem
Health plan leadership desired to improve the efficiency of the prospect pre-enrollment process by replacing several home-grown systems and Excel spreadsheets that were being used to manage pre-enrollment operations and referrer communication. In addition, the organization sought to improve relationships with referring entities by offering a self-service portal and improved case communication.

Solution
Status:Go created a pre-enrollment operations platform including desired functionality:

  • Self-service referral portal allowing inbound post-acute care providers to submit new referrals and access referral history
  • Prospect information gathering workflow allowing intake specialists to collect prospect interest, demographics, and determine eligibility, including phone system integration
  • Schedule, dispatch, and manage wait list of in-home assessors for community health assessment collection based on availability, skill set, language fluency, and geographic location
  • Assessment gathering, rework, approval, and review process for program eligibility submission, including digital document management integration
  • Automated follow-up workflow activity requirements and assessment management at predetermined intervals

Results

  • Average turnaround time for eligibility determination and approval was reduced by 41%
  • Increased efficiency of assessor workforce eliminated plan to hire additional nurses
  • Unutilized assessor availability was reduced by 11% with new wait-list management functionality

Let’s get started.

The first step: Getting on the phone to discuss your project.

Status:Go creates software for healthcare delivery organizations so they can improve operations, execute strategies, andtry new ideas.
 
We know healthcare, Salesforce, and how to get things done.
 
You’ve prepared your people for industry change with strategy. Now give them the tools to execute.

Project Experience

We’ve helped every type of healthcare delivery organization execute on a variety of strategies.

Status:Go creates software for healthcare delivery providers to improve operations, execute strategies, and try new ideas.

We know healthcare delivery, Salesforce, and how to get things done.

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