Patient-Focused Health Plan Management: What it Means and How to Get There


Amidst upheaval from healthcare reform and increased government regulations, healthcare companies today are challenged to maintain a competitive edge in an increasingly complex environment. Changes like the Affordable Care Act have expanded coverage to millions of Americans, disrupting coverage plans and resulting in higher costs. Keeping up with rapidly changing communication channels is vital as younger customer segments have higher expectations for speed, information and mobile accessibility.

As a result, the health plan industry is making a shift from business-to-business to business-to-consumer, embracing consumerism and differentiating services and offerings to achieve competitive advantage. However, the need to adhere to increased government regulation and compliance requirements remains, and the old infrastructure and systems which previously served the health plan industry have become inadequate in meeting both user and government demands.

Dynamics CRM Online HealthcareHealth plan organizations today require a strong CRM framework to support marketing, customer acquisition, retention and overall care management. Effectively managing customer relationships in order to improve customer acquisition and retention requires collaboration between departments – the ability to coordinate timely engagements and maintain accountability between each functional group. This CRM requires new levels of integration to maintain growing social and collaborative relationships with customers. Empowering consumer engagement while keeping costs low is also vital to achieve competitive advantage.

According to Dennis Schmuland, worldwide managing director of the Health Insurance Industry for Microsoft, “Hypercompetitive market pressures are driving health plans to seek simple solutions to decrease costs and points of failure in the sales process and improve member retention by executing a company-wide CRM strategy.”

Microsoft Dynamics CRM Online for health plans pursues this strategy by providing a cost-effective, cloud-based solution for managing virtually every customer-facing activity for health plan organizations. Benefits include the ability to automate and streamline tasks and processes in order to eliminate errors and free up valuable resources. Seamless integration facilitates fluid workflows and provides a 360-degree view of customers with information automatically collected in the cloud in real-time. Below are three ways that Dynamics CRM Online helps health plans facilitate patient-focused health plan management:

1. Making Group Management Easier. A major benefit of Microsoft Dynamics CRM online is its ability to streamline group management; it allows you to efficiently manage groups and their owned policies. CRM users can easily plan for next year’s changes and even copy complete policy and rate information with its cloning feature.

CRM for Healthcare is changing the game for group management because it provides the ability to customize a tailored experience for each role, whether that is the administrator, agent, customer service rep, sales manager, or marketer in order to facilitate effective collaboration and create a unified, seamless customer experience to drive sales and retention efforts. With CRM Online, users can automate the creation and assignment of tasks in order to reduce redundancy and errors that are often commonplace when onboarding new groups.

2. Report Automation and Compliance. The ability to produce reports provides much-needed visibility among members, agents, providers and employees in order to make sure important data is always in the right hands. With Dynamics CRM Online, users can generate compliance reports quickly and automatically with preset templates tailor-made for health plan organizations.

3. Enrollment and Renewal Automation. For health plan organizations, the enrollment and renewal process is often complex, taking up valuable resources and resulting in errors. Dynamics CRM Online addresses this with a single tool to manage the enrollment and renewal process, streamlining business and protecting data integrity. Automation improves workflows, accelerating the overall time it takes to add, remove, or update information.

Other benefits include telephony and Outlook integration to further expand your team’s ability to best serve customers through any communication channel. Emails, appointments and tasks are automatically tracked in CRM for each contact, and mobile capacity allows your team to access information wherever they are, from any device.

To learn more about CRM Online for health plans, email us at or click below to view or download a PDF flyer.

Learn More About CRM Online for Health Plans

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