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Navigate Health Insurance with Concierge Services

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GuideToHealth

Need a little help navigating your insurance plan or deciding if you need to see a specialist before you book an appointment?

Since the Affordable Care Act came into the picture (and even if it is gone soon), consumers have more choices. With 39 percent of ACA consumers looking to change insurers, insurance companies are looking to distinguish themselves with exceptional member experiences, not just improve on benefits and costs.

Concierge-level service differs from concierge medicine because it aims to educate and empower members with personalized service, while concierge medicine delivers an on-demand doctor for a monthly or yearly fee.

A Personal Healthcare Guide

Some concierge services are implementing teams dedicated to ensuring a positive user experience. Oscar, a New York-based insurance company, pairs each member with a specific team that includes one nurse and three care guides. The team interacts with the members—sick or not—to guide them in lowering costs, getting the most from their plans and improving their health. Every time a member contacts the company, he or she is connected with a person they “know” from his or her concierge team, meaning the conversation can pick up where it left off.

With this model, the concierge team can message or call the member He or she may introduce the member to the plan’s telemedicine service for non-emergencies, or help them use plan services to manage a specific ailment.

Because the member gets to know the team over time—and does not have to speak to a stranger each time they need something—the concierge team can anticipate the member’s needs and customize the plan to best serve him or her.

Engaging and Empowering Consumers

Not all concierge services have teams; some have individual care coordinators who do everything from managing hospital discharges to recommending in-network specialists. They know the policies inside and out, and can navigate members to perks they didn’t know were included. For a patient newly diagnosed with a condition or disease, the coordinator would alert him or her to plan benefits that specifically address the ailment.

Some companies have personalized care with custom apps and hotlines so patients don’t have to use Google—or pay for unnecessary doctor visits—when they need answers. Better service also includes transparency and cost-comparison tools, as well as access to educational resources.

When the patient experience is improved, there are values for the insurer, too. Perhaps a patient discovers he or she can use an outpatient clinic instead of incurring hefty fees from an emergency room visit. That saves the insurer money, too.

Healthcare is evolving to be about more than making sure everyone can acquire a policy. The ACA gave consumers the ability to shop for plans, which means that companies have had to change their cultures and core operations to ensure that members get the most from their policies—with the least amount of hassle.

Enroll Now for 2017 Coverage

Make sure you get coverage by December 15, 2016 so your coverage can begin on January 1, 2017. Contact Oscar.