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Health Plans: Top 10 Steps to Overcome the State Exchange Mess

Health Plans: Top 10 Steps to Overcome the State Exchange Mess

$240 Million may be needed to fix five state exchanges according to the Wall Street Journal, leading some states to consider shutting down their state exchanges to leverage the federal exchange.

In the midst of chaos and confusion, health plans must optimize their online payment service to succeed. From the initial payment that enables consumers to enroll in the insurance plan to the ongoing payment and billing process that keeps members loyal, the payment and billing process is key to success. 

Here are the top 10 steps for health plans to succeed in the midst of the chaos and confusion of the health-care exchanges.

1. Integrate seamlessly with exchanges. Whether you sign up new consumers from state, federal or private exchanges, the web user experience and back-end payment flow for accepting the initial payment must be seamless and simple for the consumer. 

2. Match or exceed options offered on state exchanges. If your state exchange offers a variety of mobile and web initial payment options, then your plan should match or exceed these options to enroll members directly with you.

3. Do not let members be denied coverage for missed payments. Some states have reported that members missing payments have resulted in members being denied insurance coverage. Rather than waiting until coverage is needed, health plans should send email and text due-date notifications to members from whom they have not received payment so that members know the status of their plan before they need to use it.

4. Stage initial payment until you approve the policy. When consumers enroll for your health plan, take the initial payment as part of the enrollment process and stage that payment until you approve the policy and then process the payment. This ensures you are paid up front and that you do not have to reverse payments from consumers who enroll, but you reject from receiving a policy.

5. Your bill is your brand. Health plans must leverage the first and most frequent member touchpoint to delight members. Rather than view the initial payment when members enroll and the ongoing bill as simply an operational tactic, the health plans that will succeed in signing up new members and retaining existing ones will view their bill as their brand.

6. Ensure industry leading security and compliance. Federal law mandates accepting debit cards for health-care insurance, but health plans do not want to end up in the headlines for exposing credit cardholder data. Health plans must ensure their online payment service is PCI compliant and ensures industry-leading levels of security.

7. Use consumer fees appropriately. Accepting card payments can decrease costs for health plans. This happens if they use a service fee model where they offer a last-minute payment service through convenient mobile, web or phone payment channels that posts the payment in real-time to avoid late fees, in exchange for the consumer paying a minimal fee. Other industries have proven this model to improve consumer satisfaction by offering last-minute payments that give consumers an option to avoid late fees.

8. Leverage your online payment service to increase website adoption. When members come to your website each month to pay, make the most of this valuable interaction to strengthen member loyalty, sign them up for additional services and encourage them to turn off the costly paper bill. 

9. Optimize online payment services for mobile. One organization found that 30% of the payments on their website were coming from mobile devices. If the bill presentment and payment pages are not optimized for mobile devices, members will be frustrated and less likely to renew their coverage with you.

10. Prepare for real-time payment settlement. In the rush to retain newly enrolled members and sign up more, health plans must think long-term as well as short-term. Real-time payment settlement will come to the United States, enabling huge opportunities for health plans. You must deploy online payment services today with the real-time payments end-game in mind.