Wipro Limited is a leading global information technology, consulting, and business process services company with more than 180,000 employees serving clients on six continents.
One of the services Wipro provides is to serve as a third-party administrator (TPA) for state Medicaid programs, which includes managing all member communications.
Delivering timely, accurate member communications is crucial to every health plan’s success. From enrollment packets and ID cards, to denial and compliance letters, to notices of benefit changes—a modern communications operation can help drive member engagement, satisfaction, compliance, and loyalty, which in turn can produce cost savings while enabling growth.
Paul Andrews, senior project manager at Wipro, is well aware of the role and value of member communications; he’s responsible for ensuring that more than 700,000 members covered by a state Medicaid plan have the information they need, on time.
For at least a decade, Wipro used a semi-manual, two-vendor approach to member communications: one vendor managed producing and mailing ID cards, while the other was responsible for all other communications.
As technology evolved over the years, so did the state Medicaid customer’s expectations, both in terms of how communications would be composed and distributed as well as how quickly they would be delivered. Wipro, in turn, asked its vendors to make changes that would enable them to meet those expectations.
For example, to confidently manage projects, Wipro needed visibility via analytics into the production and distribution status of all member records, from start to finish.
“With the ID card vendor, if they had issues on their end, we had limited visibility into that,” says Andrews. “When we sent them a correspondence file to create the ID cards, we didn’t know if what they received, downloaded, and were going to produce was accurate, and there was no way to check status along the way.”
In addition to a lack of transparency and checks and balances, Andrews and Wipro Program Manager Mahesh Mullath also had to create workarounds for production.
“When the state identifies a population of people that need to receive a particular piece of correspondence, they send that file to us, and we then identify everybody in the household who is impacted and needs to receive that correspondence,” explains Andrews. “But the print vendor we were using didn’t have the capability to take our file, generate the PDFs, and mail them. So, we had to create the PDFs.”
This meant Wipro had to have technology and people in place to manage the pre-production workflow, functions that are typically handled by the communications partner. They also had to accommodate each vendor’s capabilities for transfer and receipt of member files. This created many issues; one vendor even required CD ROMS, which only one Wipro associate had the knowledge and ability to manage.
In addition to all the circuitous workflows, Wipro also had to allow the printer extra time to meet deadlines, as limited capabilities and bandwidth meant projects were often spread over several days.
“It became very clear that our process was archaic and it needed to change,” says Andrews.
Andrews says Change Healthcare was the first vendor Wipro evaluated: “We wanted to understand the capabilities they offered, and we meticulously went through their system, talking about features and benefits, what would work and might not work, and how our environment would change. I wanted the whole process to be automated, and not have our production depend on one person.”
Andrews and Mullath discovered Change Healthcare’s Client Access System (CAS)—a user-friendly, self-service portal—was a game changer. The portal offers customers visibility into the production process, from file receipt to mailing. Inline cameras and bar coding are used to track content throughout the process, so if the customer calls with an inquiry, that specific file can be accessed in real-time to see what is being referenced. Another benefit was Change Healthcare’s efficiency in getting the right content to the right person quickly via automatic address corrections and standardization.
“Then, we looked at pricing,” Andrews says. “It wouldn’t make sense for me to transition to all of this high-tech stuff if I would have to pay a much higher price. But when we did the feasibility study, it just made sense. We were able to cut our costs from what we had been paying two vendors due to Change Healthcare’s capabilities and pricing.”
Mullath says the transition included both smooth experiences and stressful times. “As with any new process, this was a lot of change,” he says. “We had hoped to implement everything all at once, but we had to break it into two phases. Anyone who has been in this role knows there is always going to be things that come up in implementation and delivery, but as long as we can work through it and make things happen, I think that is really good.”
Fortunately, the benefits of automation and innovation were quickly realized.
“Transparency, to me, is a big deal,” says Andrews, “and with the portal, I know what’s going on all the time. We have complete visibility into the process and we can control what is released at a given point in time.
“Change Healthcare maintains all the templates for us. I can go into the portal and download the image, work with it on the fly, and see the change happen [in real time]. So, the process is a lot more agile than it ever was before. I can also see what’s scheduled to be released and what has already been released. I can take an image of the document and print it, and see the details right on the document. My staff can do all that stuff and give me stats immediately; they don’t need anybody to help them, they only need connectivity to the site and the credentials to be able to log in. To me, I think that is the best part. I don’t see us as two separate companies; I just see it as we have a department or division that handles all our correspondence—and Change Healthcare makes it happen.”
Andrews recommends that industry peers debating a transition to a new communications vendor, choose carefully:
“I think we have to embrace change and look for efficiencies, since they make everybody’s job a lot easier. And I think you need to look for an organization that has the capabilities to present new things to you, not just take over what you’re already doing, but present something new that’ll create those ‘ah-hah’ moments.”
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