New Advocacy Program Drives Customer Satisfaction

PhoneSupportIt’s not new news that health care, rightly or wrongly deserved, has a reputation for being complicated and challenging to navigate, sometimes leaving consumers of health care services with a lingering sense of discontent. For those of us in the industry, whether on the payer or provider side, know that often this reputation is not deserved. However, as the saying goes, perception is more important than reality.

The program’s goal is to minimize the pain of administrative processes for members by helping them to navigate the system – uncharted waters for many, if not most, people.

Beacon Health Options (Beacon) is doing something to align perception with reality. Working in conjunction with one of its national employer clients, Beacon launched at the beginning of 2016 its Advocacy Program, currently serving more than 2,000 members. The program’s goal is to minimize the pain of administrative processes for members by helping them to navigate the system – uncharted waters for many, if not most, people.

How it works

Often when individuals connect with health care, they are experiencing a difficult time in their personal lives; the last thing people need at such times is a wrestling match with the system. To mitigate that potential situation, Beacon’s new Advocacy Program includes a member advocate – a Beacon employee – who takes on practical administrative functions, such as:

  • Coordinate billing across multiple entities
  • Schedule follow-up appointments, if needed
  • Listen to members’ concerns and to find solutions
  • Research complex issues across multiple disciplines to resolve an issue
  • Work across Beacon departments and provider offices and have the ability to pull data from multiple databases, when necessary
  • Resolve complex claims issues

Beacon expects improved satisfaction for both the member and provider; more seamless transitions to aftercare; and decreased administrative burden.

Members are referred to the program internally, such as from a call center representative working with someone who can’t get a problem resolved or someone from Beacon’s account team who makes the referral based on customer feedback; the employer client can recommend participation as well. Typically, program participants are heavy users of services and frustrated with the care they are receiving. Members can benefit from the advocate’s services for as long as necessary.

Benefits all around

While the program is still in its infancy and too early for data, the initial response from Beacon’s client and its employees has been positive. Ultimately, Beacon expects improved satisfaction for both the member and provider; more seamless transitions to aftercare; and decreased administrative burden – primarily for the member but also for the provider.

The program rounds out Beacon’s belief that the most effective care is care that accommodates the unique needs of the individual instead of the other way around – pigeonholing the individual to accommodate the system.

The employer benefits as well. With mental illness as the number one cause of disability in the United States, its economic impact is staggering, much of it incurred at the workplace due to lost productivity, absenteeism and disability. In 2010, the economic impact of depression alone was $210 billion, half of which was associated with costs at the workplace. By facilitating the inevitable administrative functions required during an illness, the program helps individuals to be more productive and focused while at work.

The program rounds out Beacon’s belief that the most effective care is care that accommodates the unique needs of the individual instead of the other way around – pigeonholing the individual to accommodate the system. If the program proves to be successful, Beacon will look to replicate it with other clients in other markets in the pursuit of care that benefits everybody – the member, the employer, and the system at large. It is yet one more Beacon initiative to help people live their lives to their fullest potential.

Share on LinkedIn
Bookmark this on Google Bookmarks

No comments

Leave a Reply

Your email address will not be published. Required fields are marked *