Customer Experience Project (CXP): Status Report

MASSACHUSETTS

HEALTH

CONNECTOR the right place for the right plan

Customer Experience Project (CXP): Status Report

VICKI COATES

Deputy Executive Director

MICHAEL PIANTANIDA

Senior Director of IT

Health Connector Board of Directors, December 12, 2019

Overview:

Today we are providing the Board of Directors with an update on our Customer

Experience Project implementation effort, which will cover:

■ Progress with Softheon for Enrollment Premium Billing (EPB) implementation

■ Progress with Faneuil for Contact Center/Back Office implementation

■ Progress with Electronic Data Management Center (EDMC) for mail room

implementation

■ Upcoming activities for the month of December

■ Risks the project is managing

H HEAL.r'H CONNECTOR 2

Current and Future State: Customer Service and Business

Operations for Non-group Membership (Refresher)

Current State: NTTData Customer Service and

Business Operations

Enrollment and Premium Billing,

Member Bills and HIX Notices,

Payment Portal

Ombudsman

Contact Center &

Back Office, CRM,

Document Processing,

Mailroom

Walk-in Centers

EPB

lnsourced

Mailroom

Contact Center

Future State: Multiple vendors selected through

ongoing procurements and other service

opportunities

Member Portal (Softheon)

Enrollment and Premium Billing,

Member Bills and HIX Notices,

Payment Processing (Softheon)

Ombudsman (CCA Staff)

Mailroom (EDMC)*

Contact Center,

Back Office, & Document Processing

and Verifications (including Walk-in

Centers) (FANEUIL)

*EDMC is the Electronic Data Management Center managed

by MassHealth and located in New Bedford, MA

H HEAL.r'H CONNECTOR

CXP Implementation - Key Dates

2019 2020

Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

Contact Center Implementation

Customer Relationship Management (CRM)

Customer Interaction Centers (CICs) ♦

6/28Sit Visits

Comp/et

♦

7/19 Nati

Apparent Successful

Bidder ♦

8/19 Board Presentatio

9/3 - 2/15 Initiating Pro ct Activities

12/9 - 3/31 Establish Con ectivity, Perform

ntegrated Testi , Validate Testi g R u/ts

4/15 - 5/31 Operational Readiness

5/31

GOLIVE

Softheon Implementation

Enrollment & Premium Billing

Notices

Member Portal

6/19 EPB& Notices BRO Sign-oi

7/19♦

Member Portal BRO Sign-Off

7/ 9-2/20 Softhe n Application

Oevelopme t & Configurati

12 13 Prima

Oa Conversi

Co plete

'/20-ember ♦

Orta/ omplete

12/9 - 3/31 lntegratio Configuration

3/30 lntegratio Complete

Testing

♦ 4/15 Pre-Production

Sign-Off

♦ 4/13 - Cut-Over Plan Complete

4/15 - 5/31

Operational

Readiness

5/31

GO-LIVE

Trainin

We are here MASSACHUSETTS

['ft... HEALTH CONNECTOR

4

Enrollment and Premium Billing Implementation

Softheon Implementation for Enrollment & Premium

Billing: Progress to Date (Road to June 1, Z0Z0)

Member portal (in progress)

■ Business requirements are almost complete

■ Functional design, including screen layouts and wireframes, are under review

■ An initial round of usability testing was completed by third party vendor and results incorporated into design

Notices (in progress - risks identified)

■ CCA Leadership was on-site at Softheon headquarters last week to discuss state of this development work

■ A mitigation strategy was proposed which includes adding 8 developers and additional sprints to complete development

■ This is a risk being actively managed and, at this time, Softheon believes they can finish all the work in time for end to end testing

on 2/3/20

Integration activities (in progress)

■ Softheon has successfully completed multiple round trips test for HIX effectuation and enrollment services (though the data sets have been very small)

■ Softheon and Faneuil have established initial system connectivity and continue to work through the details to connect the Interactive Voice Response (IVRs)

Data conversion (in progress)

■ The Softheon team continues to work on importing and validating full data conversion including enrollment counts and balances

• Results to date are within acceptance tolerances

• 2020 OE auto enrollment activities have completed. Current test cycle includes 2020 plan year data; results of this run will be available shortly

■ Currently testing incremental data conversion approach

• This approach would reduce conversion work over the go live weekend and potentially allow for parallel data validation with production data in advance of go live


Softheon Implementation for Enrollment & Premium

Billing: Progress to Date (Road to June 1, Z0Z0)

Multiple rounds of testing completed and will continue through go-live with a primary data conversion milestone in December.

Data Set

Enrollment

Payment

Notices and Paperless

Preferences

Banking Data

Description

All 2018 and 2019 Enrollment Spans

All 2018 and 2019 financial

transactions (created to date)

2015 - 2019 (to date) EPB and HIX

notices

Autopay and EFT configurations

Status*

Current matching statistics against NTT Data for full data set:

• Health: 99.9% match • Dental: 99.9% match

Current matching statistics against NTT Data for full data set:

• Health AR Balances: 99.9% match • Dental AR Balances: 98.8% match

• Full data set (meta data) imported and analyzed • Remaining discrepancies being remediated

• Transition of full 17 TB data set to production targeted for

January 2020

• Full dataset imported and analyzed • Validation and reconciliation in progress

* Status as of November data import round; December import round results pending.

Not part of data conversion per se, but metrics for ratable members, ad min fees and state mandated benefits (SMB) will be calculated and validated.


51 Unique Notices Needed for Go-live Each notice has multiple business rules which need to be built and tested in order

to ensure the notice is published correctly.

Notice Type Enrollment, Eligibility, Open Contact Center Closed Enrollment Health

Premium Billing, Enrollment Connector

and Tax

Documents

Back End- Softheon HIX XML Faneuil HIX CSV - CCA

Integration or Remedy - Trigger Integration Integration Integration lntegration

Trigger

Template 26 English 9 English 8 English 4 English 4 English

16 Spanish 8 Spanish* 8 Spanish 4 Spanish 4 Spanish

(10 Spanish)

Fulfillment Large Print

English & Spanish Braille Large Print and Braille: New for Enrollment Premium

Billing, Contact Center, Closed Enrollment and Health

Connector noticesHouseholding (where able)

*The IDP notice does not need to be in Spanish since the customer has not yet chosen a language preference

=Red new as of June 1, 2020


I

Softheon Im.plem.entation for Enrollm.ent

Prem.ium. Billing: Key .Activities for Decem.ber ■ Anticipate meeting mid- December primary data conversion milestone, which

includes enrollments, payments, notices and banking data

■ Review approach for system cutover, including incremental data conversion

■ Functional development continues, including enrollment and billing, notices

and member portal

■ CCA will continue to closely monitor the development of the notices track to

ensure mitigation plan is working

■ Begin preparation for CMS Authority to Connect (ATC) through the HIX

program


Contact Center Implementation

Faneuil Implementation for Contact Center & Back

Office: Progress to Date (Road to June 1, Z0Z0)

■ Working sessions with CCA IT and Operational SM Es (in progress)

• Oracle Customer Relationship Management (CRM) taxonomy development

• Trajectory (service center system) content and workflow handling of member interactions

■ Integrated Voice Response (IVR) initial discovery sessions held (in progress)

■ Walk-in-Centers (in progress)

• Received proposals from Faneuil real estate team for Boston and Worcester locations

• Decision made to stay at current locations for now

■ Documents for satisfaction of the mid-November Milestone were received (in progress)

CCA requested revisions and additional material be added prior to acceptance

• Milestone final review and acceptance being moved to mid-December

• Change does not impact overall project timeframes

■ Collaboration between Faneuil and Softheon continues (in progress)

• Agreed to use Faneuil Oracle application for Member Portal service requests

• Working on format/process to pass required static forms data to Softheon for fulfillment


Faneuil Im.plem.entation for Contact Center &

Back Office: Key Activities for Decem.ber ■ NTT Salesforce data will be converted into Faneuil Oracle CRM in anticipation of

finalization of primary data conversion load and testing by mid-January

■ Working sessions with CCA IT and Operational SM Es continued with goal to finalize

regards:

• Oracle Customer Relationship Management (CRM) taxonomy development

• Trajectory (service center system) content and workflow handling of member interactions

■ Walk-in Centers

• Expect to reach agreement in principal for CICs leases

• Work with NTT to develop a plan to transition NTT employees to Faneuil (if possible)

■ Begin preparation for CMS Authority to Connect (ATC) through the HIX program


Mailroom Implementation

Electronic Data Management Center (EDMC)*

Implementation for Mailroom: Progress to Date and

December work (Road to March 21, Z0Z0)

■ All business requirements have been finalized (complete)

■ Development work continues and is on track and there are no issues identified at this

time (In progress)

■ The previous mail room was at Portland Street in Boston . A new P.O. Box address was

required - it has been purchased and this address will be incorporated into all

correspondence (complete)

■ Progress continues as planned for 3.27.20 go-live

*EDMC is managed by MassHealth and is located in New Bedford, MA

H HEAL.r'H CONNECTOR :L4

Risk Management

Risks Being Actively Managed:

Risk

Integration with Optum and HIX

en roll ment/ effectuation/noticing

interfaces

Historical knowledge and data from NTT

Completion of the notice development

track in time for end to end testing

All business requirements not yet

finalized

Mitigation

Closely monitoring work progress with

active management of Optum staffing plan

Meeting regularly with NTT Leadership

regarding transition, needs and timing

Softheon adding more development

resources; business prepared to prioritize

scope if needed

Business teams meeting with Softheon to

finalize all business requirements by end

of December

H HEAL.r'H CONNECTOR 1.6

.Appendix

Custom.er Experience Procurem.ent Project

(CXP) - Refresher

Background:

■ There are two major components of the overall service delivery that the Health

Connector provides to its members, one being, the contact center, back office, and

document processing and verification services and the other being premium billing

■ The current NTT contract expires on June 30, 2020

■ In 2017 a Customer Experience team was launched to create a strategy and path for

procurement which included smooth transition of services at the end of the contract

with NTT

Goals of the CXP team:

■ Maintain operational stability in key areas of Enrollment, Premium Billing, and

Contact Center

■ Improve customer experience to meet members' expectations

■ Rebase the cost structure so as membership grows, economies of scale are realized

H HEAL.r'H CONNECTOR 1.8

https://Custom.er

Softheon: Im.plem.entation Milestones

The Health Connector has worked with Softheon to identify critical

milestones that must be achieved throughout the implementation.

Implementation Milestone

1 Business Requirements

2 Primary Data Conversion

3 Member-facing portal readiness (Equity

Portal)

4 Integration

5 Pre Production

6 Operational Readiness

7 Full Solution - Go-Live

8 Warranty Period

Projected

Completion Date

June 2019

December 2019

February 2020

March 2020

April 2020

April 2020

May 31, 2020

6 months post

go-live

Status

Completed


Faneuil: Im.plem.entation Milestones

The Health Connector has worked with Faneuil to identify critical milestones that

must be achieved throughout the implementation. Where applicable, dates align

with the Softheon milestones.

Primary Implementation Milestones

Facility build out plans and approach 1

Initial Mobilization and Baseline Project Plan2

CRM Requirements Gathering & Discovery3

CRM Stage 1 Build and Primary Data Migration4

Facility Connectivity and Staffing - Stage 15

Base Development & Configuration6

Integration Testing with all External Systems 7

Operational Readiness including Staffing 8

Full Solution - Go-Live9

Warranty Period - all defects resolved10

Projected

Completion

Date

October 2019

October 2019

November, 2019

December 2019

January 2020

February 2020

Status

Completed

Completed

Under

review

March 2020

April 2020

June 1, 2020

6 months 22