5 Strategies for a Less Painful Dependent Eligibility Verification
Dependent eligibility audits can be conflicting to benefits professionals who manage them. On one hand, they are essential for keeping your organization’s healthcare costs low — especially now. Not only do healthcare insurance premiums continue to rise, but under the new Affordable Care Act, dependent children up to the age of 26 remain eligible for coverage regardless of marital status. And case after case shows that a dependent eligibility verification (DEV) can save millions if even a small percentage of ineligibles are removed.
On the other hand, eligibility audits can lead to confusion, frustration and anger among employees. It’s easy to misunderstand the purpose of eligibility audits, and let’s face it: rustling up various legal documents isn’t fun for anyone, no matter how organized they are. And for benefits pros, DEVs can be a tough sell culturally, and time intensive too.
Thankfully, verifying dependent eligibility doesn’t have to a painful experience anymore. A lot has changed — processes have improved, technology has advanced. Each project step can now be tracked, monitored and measured. More channels of communication have opened up to better explain what’s happening to employees, and why. HR professionals can benefit from on-demand visibility into the entire process.
Let’s take a look at 5 ways to make your next dependent eligibility audit less painful and more efficient and effective:
1. Start with a specific, quantifiable plan. You’ve heard it before, but it’s worth saying again: upfront planning is the most important aspect of a dependent eligibility initiative. So what does that really mean? We believe that you need to architect a blueprint of the specific activities that must be done, when, by who, and how many estimated hours it will take. Use previous experiences to form your plan. Be sure to include success metrics. When it comes to eligibility verification, positive results are directly linked with measurable goals and project organization.
2. Communicate with a steady drum beat. Create a thorough communications plan that considers all the ways you can reach your workforce. Devise a strategy to tap these various channels not just once, but in a cadence designed to inform, educate, reinforce, and remind employees about the purpose of the eligibility audit, guidelines, what actions they must take, FAQs, where to seek information and help, and deadlines. Communication channels include mailed letters, email, facility posters, payroll stuffers, corporate newsletters, department meetings, and the corporate intranet.
Moreover, go beyond words — use pictures and video. People retain information differently. Appeal to visual responders with headlines and graphics on posters. Experiment; your DEV can be a reason to finally test the effectiveness of video. (For example, post a 2-3 minute explanation on the merits of eligibility verification on an internal website page along with a FAQ and other key information).
3. Tap technology for process automation. To optimize dependent verification effectiveness, seek out newer, web-based applications that house details for each employee and their dependents. These applications record every activity — case-relevant documents are imaged and uploaded directly to the case, eliminating the need for paper files; all incoming and outgoing phone calls are logged by user, date and content of the call. Overall case status (e.g., complete, incomplete, or no response) is automatically maintained and can be viewed individually or in aggregated. These applications also make life easier for employees, who can view their progress and receive confirmation when their response is complete.
4. Leverage analytics for insightful reporting. On-demand reporting and analytics can measurably improve a dependent eligibility initiative. By tracking and monitoring each step, you can see what’s working and what’s not, and thus drive process improvements. Web-based dashboards — available through some DEV specialists and vary in sophistication — enable entirely new levels of transparency. You’ll have access to real-time reports such as letter status (number of letters mailed, responses, amnesty removals, non-responders, returned mail…) call center statistics, and a variety of other reports, such as weekly status, eligibility status, weekly project status, appeals, imaged documentation, and more.
5. Outsource if possible. If any of the above sounds daunting, then outsourcing may be for you. More companies are partnering with dependent eligibility audit specialists because DEVs are a huge drain on resources. Small companies are more likely to handle eligibility projects themselves, although many are recognizing the worth of a good vendor in terms of freed manpower and cost savings after considering things like printing, mailing, resources needed for call center support, and so on.
There are innumerable benefits to outsourcing to the right vendor. DEV specialists can apply their ample experience to manage DEVs with high proficiency. With the right partner, instant value can be gained with their planning and project management expertise and ready-to-go DEV instrastructure — such as template letters, response portals, call center staff, print-to-mail operations, document imaging and digital filing, analytics and reporting, and more. Best of all, your time investment will be minimized while you still maintain control.
When evaluating potential DEV vendors, be sure to ask about the following:
- Workflows, methodologies and best practices. What processes are in place to deliver a successful DEV? In what ways are they modernized, flexible, automatic, customizable?
- Technologies for automation, transparency, and reporting. What tools help manage the DEV? What tools provide real-time visibility into project status? As for sample reports.
- Staffing and support. Who will lead the project? What is the team structure? What are their qualifications and backgrounds?
- Data privacy, security and contingency backup. How is employee data protected? What disaster plans exist to avoid worst case scenarios?
- Alignment with corporate culture. How will the vendor ensure sensitivity to your company’s philosophy, beliefs and culture?
Given the potential for major cost savings — anywhere from 4% to 8% reduction of ineligibles on average, sometimes as high at 10% or more — it’s no wonder that eligibility audits have skyrocketed in recent years. But too many efforts rely on outdated methods that fail to take advantage of the latest advancements in process and technology. If you’re ready for less pain and more gain, give these no-fail DEV strategies a try next time.