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ANNOUNCEMENTS

Utilization Management: Case Study

BACKGROUND

A Health Plan client with a high-volume of Utilization Management letters needed to find a solution to efficiently mail letters the same day to meet challenging regulatory requirements. In some cases, documents needed to be mailed within hours of receipt and the client required a response file evidencing mail date. Cost was a major consideration as there we specific budgetary restraints and requirements to transition to a new vendor.


APPROACH

Command Direct conducted a comprehensive analysis of the current workflow challenges, and requirements. Our technology team gathered specific details related to file receipt, allowing us to fine-tune our automation for the required timeline. Simultaneously, our mail data team evaluated the client’s postage strategy, seeking opportunities for cost reduction and efficient handling of return mail. Additionally, our account management team facilitated discussions with the client project team to identify workflow efficiencies and enhance communication.

UM Pro Case Study
Utilization Management Case Study

SOLUTION

A specialized workflow was crafted by Command Direct to facilitate material production on both coasts, strategically leveraging the later Pacific Standard Time (PST) drop times. Our innovative automation system also generated cover sheets designed to be visible through a window, ensuring seamless fitting for both large and small letter files. This approach allowed us to capitalize on reduced postage rates—an advantage not previously offered by the client's former vendor. Additionally, operating in two facilities enabled our mail data team to incorporate an additional layer of postal processing, including barcodes and postal discounts. All these services were developed and continue to be managed by our dedicated project team.


RESULTS

The solution Command Direct provided checked all of the boxes:


  • Same Day Mailing: Creating an automated approach to capturing files, appending a cover sheet and mailing in waves throughout the day allow for the expedited requirements

  • Regulatory Adherence: The return reconciliation files we provide shares mail dates in accordance with requirements and offers a method of measuring success

  • Meeting Budgetary Requirements: Command Direct's automation allowed for production discounts due to the elimination of manual steps. In addition the postage discounts realized provide a layer of savings that the client was not aware was available. In total, Command Directs solution resulted in almost 20% in total cost reduction.



Download Utilization Management Case Study

 

This project has been in place for over three years and our team continues to adapt to the ever-changing requirements. This project is a very good example of the creative and flexible approach Command Direct brings to Health Plan Challenges.


Leverage Command Direct’s expertise to enhance your communication strategy, ensuring every letter is delivered accurately, efficiently, and on time. Contact us to discuss our comprehensive suite of electronic noticing options.

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