Meeting Your Members Where It Matters Most: Providing High-Touch Support at Their Fingertips

These days, consumers have many options available to them when shopping for health plans, but one thing remains the same no matter what option they choose. They want to feel like they are heard and being supported. The industry is focusing more and more on the member experience – STAR ratings, CAHPS measures, member loyalty and most importantly member retention.

To have a high-rated member experience, you must work towards increasing your levels of member engagement. According to the J.D. Power 2021 U.S. Commercial Member Health Plan Study,SM more than one-third (37%) of health plan members had no engagement with their health plan.1

For health plans looking to increase their member engagement, elevate their member experience, and provide high-level customer service, consider these four areas to boost satisfaction and support members where it matters most.

Comprehensive Benefits Overview

A survey conducted by OnePoll on behalf of Bend Financial found a staggering 56% of Americans have recently admitted to feeling “completely lost when it comes to understanding health insurance.”2 During their survey, they asked health plan consumers a series of questions, and here is what OnePoll found confuses these consumers most:

  • What counts towards deductible (52%)
  • What procedures are covered (47%)
  • What’s in or out-of-network (47%)
  • What can I use FSA/HSA on (43%)
  • If I qualify for discounts (28%)
  • Do I even have coverage (15%)

As a health plan, you can alleviate this confusion by providing resources that help your members understand their coverage. Through your member portal, show up-to-date information regarding what is available to them with their benefits or even plan discounts, explain and outline their deductible and out-of-pocket maximums in a member-friendly manner, and inform them of their benefit accumulators for both in-network and out-of-network services (e.g., 8 of 12 allowed acupuncture visits have been used so far this year).

24/7 Self-Service

Your members, like everyone else, are constantly moving and on-the-go. We all live busy lifestyles and we need our health plans to keep up with us. Whether it’s needing an ID card in a pinch or updating their primary care doctor because of a recent switch, on-demand, 24/7 access to important policy and plan information is necessary. As you either build out or enhance your member portal, consider adding in self-serve tools your members can access anytime, anywhere. Here are a few must-have features:

  • Download, print, and request ID Cards
  • See claims history
  • View referrals and authorizations
  • Ability to update demographic information
  • Update PCP’s and other physicians

Customer Support

Your members are your customers, and they deserve the highest level of support. They may have a quick question about their plan coverage, need more details around a recent processed claim, or they may need to file a grievance or reconsideration of a claim. No matter the reason, the important thing is that you are there for them when it matters most.

Let your customers skip the hold music and get the help they need without picking up the phone. By offering live chat and secure messaging, members will have online access to support by your customer service team at the exact moment they need it in a convenient way. These are two secure methods that can offer instant problem resolution, leading to a valuable member experience and a satisfied member.

Health Tools

Members need the tools to educate themselves about their health and available options so they can make informed health decisions and improve outcomes. Relay information about prices for medical procedures and visits, the nearest in-network physician, and other health-related topics through your digital engagement platform. This will keep your members engaged, educated, and connected to you throughout their health journey.

Take it a step further and provide a solution for member, provider, and care manager collaboration. Members may be at a point in their health where they need that support from you and their care team. Being there for them and extending these resources and tools will lead to members being smart and proactive about their healthcare decisions, and ultimately more satisfied with the care they are receiving and your health plan.

Get Started Today

If you are looking to support your members by providing them with the tools they need to make the most out of their health insurance, HealthTrio has the product portfolio to help you get it done. Reach out to us today to schedule a demo and let us assist you in building out your customized engagement platform.

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