3 Data Management Tips for Winning the Rest of ACA Open Enrollment

January 16, 2015
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After an ignominious start in 2013, Healthcare.gov is functioning smoothly in this round of open enrollment – and for insurers, that means a flood of new data entering their systems.

“Compared to the rough start last year, the experience this year is like night and day,” Enroll America Anne Filipic told U.S. News and World Report. “The website is more stable, and thanks to a streamlined application, many consumers are able to complete the process with far fewer clicks than during the first open enrollment period.”

After an ignominious start in 2013, Healthcare.gov is functioning smoothly in this round of open enrollment – and for insurers, that means a flood of new data entering their systems.

“Compared to the rough start last year, the experience this year is like night and day,” Enroll America Anne Filipic told U.S. News and World Report. “The website is more stable, and thanks to a streamlined application, many consumers are able to complete the process with far fewer clicks than during the first open enrollment period.”

Up to 9.9 million people are expected to enroll in healthcare plans through the exchanges this year, according to U.S. News – a lower number than anticipated, but still nothing for insurers to sneeze at.

While 37 states use Healthcare.gov for their exchanges, 13 states and Washington, D.C., have their own websites to enroll the newly insured, as well as people who wish to alter their insurance plan. That means data comes from more than a dozen different sources, all with slight variations based on the state.

Some states have experienced glitches, which makes data collection and processing all the more complicated for insurers that want to make sure they have every bit of required information about their new customers. Washington state, for example, accidentally canceled 6,000 active accounts, while enrollees in Colorado were kicked off the site in the midst of signing up for coverage.

With open enrollment well underway, here are a few tips to make sure your data stays accurate, regardless what might be happening in the marketplaces.

1. Manage Edge Server Data

Accurate enrollment data sets the stage for full reimbursement later on. Not only will you miss out on those valuable funds if your data is faulty, you’ll also be out all the time (and related costs) spent investigating and fixing the problem records.

A solid edge server data management system automates data management and preparation through the entire life cycle, so you know you can trust the information from the moment it enters your system. You’ll save time and talent while having the peace of mind of knowing you’re functioning with enrollment data you can trust.

2. Automate Membership and Payment Reconciliation

Have I mentioned the amount of data flooding insurers systems? Millions of newly insured people create billions of bits of data, which can make reconciliation a challenge.

But implementing data integrity controls eliminates some of the worry. Controls help you track membership processes through easy-to-interpret reports and dashboards, allowing you to quickly spot and resolve any inconsistencies.

3. Reduce Claims Processing Errors

OK, you have hundreds of thousands of new customers. Now what? Keeping claims processing on track from the start ensures your business stays ahead of any potential problems that might await down the road.

Automated data integrity controls help you detect inaccuracies early, as well as identify new or unauthorized claims submitters. Root out missing claims by analyzing them in batches, which streamlines the process. And reject duplicate or error-filled files before they mess with your system, so you know you can trust every piece of data.

While open enrollment can be a stressful time for insurers, employing controls helps rein in the pain.