The Health Plan

The CODY^® client featured is a nationally ranked managed care organization (MCO) located in the Northeast. With more than 60,000 members, it offers Medicaid and Medicare Advantage plans to individuals and families. CODY^® provides outsourced document development services and 508 remediation services for this client’s Medicare Advantage plans.

The Challenge

Prior to outsourcing production of its Medicare Advantage member marketing materials to CODY^®, the health plan was experiencing significant challenges with document accuracy, on-time delivery and costly erratas.

“Previously, the materials were hand-done internally by a group that didn’t have the expertise regarding the information needed,” said the plan’s Director of Marketing. “There were a lot of inaccuracies and we were providing the wrong information to members. At one time, after we sent out our yearly mailing, we had to issue an errata that listed 18 different errata issues on that document.”

The Solution

In 2015, the plan decided to outsource production of its Medicare Advantage Annual Notice of Changes (ANOCs) and Evidence of Coverage (EOCs) documents to Cody. Through its Business Process Outsourcing services, CODY^® oversees all aspects of production, including: project kickoff; program management; monitoring timelines; building materials; coordinating approvals; and printing and mailing.

With first-hand payer experience, CODY^® experts are intimately familiar with the complex ANOC and EOC collateral creation process. The majority of CODY^® team members are former health plan employees who were directly involved with the development of required communication materials, and understand the resource limitations and compliance challenges faced by MCOs due to increasing oversight of CMS.

CODY^® outsourcing solution for the creation of required plan documents offers an advantage not available elsewhere – the CodySoft® Collateral Management Module®. CODY^® consulting team creates plan documents within this program, allowing for a more streamlined process and accurate final output of materials.

“Working with CODY^® has brought a process to the development cycle of our ANOCs and EOCs that has removed errors through automation.”

The Results

The most significant benefits the plan has experienced since outsourcing materials creation to CODY^® are improved internal collaboration, on-time delivery of materials to members, better customer experience and reduced operating expenses.

The first year the plan worked with CODY^® was errata-free. Also, when the health plan faced budget cuts, it worked closely with CODY^® to figure out how to combine certain materials into one document rather than producing multiple versions. Decreasing the printing variations saved the plan around $500,000.

“There’s a financial savings as a result of not having to mail erratas,” said the plan’s Director of Marketing. “And in collaborating with CODY^® to work through our financial constraints, they helped us find a half-million dollars in savings.”

The plan has also seen a vast improvement in internal collaboration on production of the ANOCs and EOCs, which ultimately leads to greater member satisfaction.

“The processes and tools the CODY^® team has brought to creating the materials is forcing someone inside our Medicare product team to collaborate across pharmacy, grievances, appeals, all these different areas. Sometimes, it’s the little things you miss, and the CODY^® team has been able to help us put forth a data set of questions to go and have those conversations that have ultimately led to better customer experience in utilizing our benefits.”

The Experience

CODY^® is diligent about monitoring and communicating rules and regulations from CMS, including the frequent Health Plan Management System (HPMS) Memos, in order to ensure material compliance.

“We typically get new information from CMS or our compliance team, but most of time we’ve already seen it from CODY^® five business days prior and been asked what direction we’d like to go, with options and recommendations. The steering and direction CODY^® provides around CMS and the info it puts out is very good.”

CODY^® Business Process Outsourcing services also drastically reduce the amount of time and effort required of a health plan’s internal staff during the ANOC/EOC creation season.

“Coming from an environment where I’ve worked with six or seven different folks who do ANOC and EOC composition, the biggest benefit of CODY^® is – what may take someone else hours to do, CODY^® is doing in a fraction of the time, and CODY^® needs minimal time requirements from their clients to do that. For example, what may have taken someone 100 hours of work leading up to kickoff may now only take 10 hours working with CODY^®.”