Our customers tell their stories bestHealth Plan Staffing and Enrollment Customer Stories

Dell - Internal Use - Confidential

Improving agility to meet unpredictable requirements

Read the case study at Dell.com/CustomerStories

Published: February 2015 | Expires: February 2017

Business needHealthMarkets sought a third party that could help its employees meet unpredictable spikes in workloads and rapidly changing business requirements including cost constraints.

Benefits● Reduces the cost of processing 90,000 claims a month by 40

percent● Lowers the expense of managing 40,000 calls a month by 57

percent ● On-demand, efficient staffing to meet rapidly changing

requirements● A partner that cares

SolutionThe organization partnered with Dell Services to help manage insurance claims, promptly answer inbound calls from providers and lower operating expenses.

”We consistently received excellent service from Dell. At peak times, Dell Services processed up to 90,000 claims per month, and they helped us lower our claims processing costs by 40 percent.”

Denise Cotter, Vice President of Operations, HealthMarkets

Dell - Internal Use - Confidential

Delivering secure and accurate enrollment and billing data to 14+ state health plans

Solution

By leveraging 30+ years of Staffing Experience, and using Dell Boomi integration platform as a service (iPaaS), Dell Services was able to develop the required enrollment and billing components in just four weeks and have them live with several insurance carriers within two months. Dell was able to customize the functions for the 14 health plans within the two-month timeframe.

Benefits

• Rapid development and implementation

• Saved $10M+ by automating processes

• Reduced administration costs for insurers, helping to keep rates low for consumers

• Mitigated the risk of compliance failures and resulting loss of public confidence in the exchange

Business need

Members need coverage in the qualified health and dental plans offered by the state exchange. And the data needed to be accurate.Data needed to be delivered to 14+ health plans in a standardized, HIPAA 834 & 820 formats for the exchange.This customer had been waiting six months for a previous vendor to properly automate enrollment and billing. This became a critical need past the go-live open enrollment date.

Dell - Internal Use - Confidential

Natural disaster spurs healthcare teleworking

Solution

• Supplemented disaster recovery efforts to support business continuity

• Maintained internal service levels, helping to meet year-end reporting requirements

• Kept 700 displaced employees engaged and productive for three months

Benefits

• Established Teleworking as a viable long-term model

• Upheld internal service levels and reporting requirements

• Improved morale and productivity of displaced employees

Business need

The customer needed to maintain threatened business continuity through remote connectivity and re-establish productivity and employee morale.

Dell - Internal Use - Confidential

Provide flexible staffing solutions for a health plan challenged with seasonal claims backlog

Solution

Dell Healthcare Staffing Services quickly sourced and recruited over 30 experienced claims professionals, deployed Dell equipment mirrored to customer specifications and provided team leadership capable of assisting customer trainers to get the team up and running quickly. Total turnaround time: Less than 30 days.

Benefits

• Rapid response, trusted partner• Fully screened, Dell employees• Flexible duration w/possible

redeployment to other areas of need

• Leverage customer’s existing systems and technology via Dell equipment

• No space required or seat allocation costs at customer location for increased staffing

• Temp. to perm. available to customer

Business need

Health Plan sought a third party that could quickly provide temporary senior claim examiners to process claims resulting in reduction of end of year backlog.

Dell - Internal Use - Confidential

“Dell’s audit service function brings us to a higher level than any of our peer organizations.”

Solution

• Recruited & trained a team of dedicated claim auditors

• In conjunction with customer, completed the required knowledge transfer to the Dell audit team

• Assumed responsibility for the customer’s claim audit functions

• Developed a program to track and report the audit results

• Established regular customer meetings to review project results and plan future initiatives

Benefits

• Redirect audit staffing resources to other responsibilities

• Received a statistically valid claim audit report from the Dell Audit Tool to meet management review and results requirements

• Improved and sustained quality health claim adjudication for members and provider partners

Business need

• Develop an independent quality audit process for medical claims

• Receive statistically valid audit results

• Continually improve performance

Dell - Internal Use - Confidential

A trusted partner since 1999History with Harvard Pilgrim Health Care

Transitioned work

Improvedquality

Reducedcosts

Created stability

Enhanced collaboration

Trusted partners

Strengthened data insights

• Infrastructure and Claims System Support

19992000

20032004

20052006

20072008

• Business Process Outsourcing

• Business strategy and consulting

• Claims processing solutions (10.1 million per year)• Received the Excellence Award

• Applications standardized • Achieved #1 Commercial health plan in America by U.S. News and NCQA

• Application consolidation• 2nd year named #1 Commercial health plan in America by U.S. News and NCQA

• Data Warehouse solution• 3rd yearnamed #1 Commercial health plan in America by U.S. News and NCQA

• Extended contract for 13 years

2009 to

2021

• Re-invest in dynamic technologies and processes to respondto change

Thank you!

Discover more customer stories at Dell.com/CustomerStories

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