Harvard Pilgrim Health Care launches new onboarding tech

Harvard Pilgrim Health Care has announced it is offering a new technology called SmartStart to help ease the onboarding process for new members.

According to Harvard Pilgrim, SmartStart will help members through a health plan transition experience by engaging them early and capturing relevant data to keep costs down and to ensure uninterrupted care and accurate claims.

Roberts-Beth-CROP.jpg
Beth Roberts

“Signing up or switching health plans can be a pain point for many members and employers,” says Beth Roberts, senior vice president of commercial business at Harvard Pilgrim Health Care, a family of companies that provides health benefit plans, programs and services to more than 3 million members, mainly in New England. “With SmartStart, we are helping ease this transition with integrated, data-driven supports that begin before the effective date to guarantee uninterrupted care.”

With the help of SmartStart, new Harvard Pilgrim members receive a pre-enrollment phone call to help them understand the details of their health benefits and coverage. They also receive clinical transition support from nurse care managers who can help with prior authorizations and pharmacy coverage. The program also includes education for employers to help them identify, recommend and implement self-service options to their employees.

SmartStart includes a guided, digital welcome experience for members to input health information, verify their primary care provider and access their digital ID card, according to Harvard Pilgrim.

SmartStart users also receive access to MyHealthMath, an integrated, data-driven solution that will provide predictive modeling to help members understand the cost of their healthcare and help them choose the best plan options, based on their financial interests.

Portland, Maine-based MyHealthMath, with direct and SaaS clients throughout the U.S., uses innovative decision-support technology to simplify health insurance planning so people can choose plans that best fit their needs and support their optimal health, the insuretech company says.

MyHealthMath has announced a new claims-based decision system to help consumers choose optimal health plans. “Less than 10 percent of employees update their health benefits during open enrollment, and more than half admit that avoiding this annual stress costs them money—probably a considerable amount,” according to executives at MyHealthMath.

MyHealthMath’s new individual Claims-Based Health Savings Report, coupled with phone-based consultations with analysts, eliminates confusion, the company contends. “The report uses an individual’s own claims data to forecast the cost of each of their health insurance options for the following year,” MyHealthMath executives say. “Employees can speak with MyHealthMath analysts to discuss and update the report to include their personal forward-looking information. The result is an individualized, side-by-side comparison of the predicted savings available with the optimal plan—potentially worth thousands of dollars in savings.”

Health insurance claims provide reliable retrospective information about health expenses, but this information is often not easily available or comprehensible to healthcare consumers, according to MyHealthMath, which can crunch the numbers and provide a consumable format for potential health plan members.

For reprint and licensing requests for this article, click here.