Health Cloud: The New Payer Data Model

Health Cloud: The New Payer Data Model

Built on the world’s #1 CRM platform, Salesforce’s Health Cloud solution is quickly becoming the new payer data model. Why? It offers a complete view of members in a single dashboard, driving productivity for service agents and clinical professionals. Simply put, the insurance market is recognizing the urgency that it needs to adapt to today’s smart, data-driven marketplace.

Salesforce® first introduced Health Cloud in 2016 to transform the way healthcare and life sciences organizations connect with patients. In 2019, Salesforce continues to expand the power of Health Cloud with features specifically built for the health insurance industry. This allows companies to engage with both members and providers in smarter and more efficient ways. Here’s how it’s done, including examples of “better outcomes.”

Transforming Business Operations

Health Cloud transforms business operations with an insurance-specific data model that simplifies the integration of systems of record — including benefits, claims, and authorizations — into one place. This drives more productivity for service agents and clinical professionals. With all member information in a single dashboard, payers are able to work faster and smarter. In addition, they better understand each member’s needs. And that includes whether they are in the call center or in the place of service, and from any device.

The Better Outcome: A payer today often needs to log into multiple systems to research different aspects of a member’s claim for an upcoming procedure. With Health Cloud, they can now see all of the member’s prior authorization and information about the procedure in one place. That allows payers to serve both members and providers quickly and efficiently.

Better Streamlined Workflows

Healthcare requests — that might include prior authorizations, admissions, and appeals — can be now be streamlined through guided, collaborative, and measurable workflows directly within Health Cloud. Agents, clinical professionals, and medical directors are able to deliver more personalized and appropriate care in a more cost-effective way.

The Better Outcome: A provider previously treated a member who needed surgery had to submit a prior authorization request to the payer. Often times that meant the provider had limited visibility into its processing. Now, with Health Cloud, the provider and member have the ability to easily view the progression and status of the request. That reduces any stumbling blocks or delays. Once a care request is approved, tasks are triggered automatically for case management based on the diagnosis or service code within Health Cloud.

Strengthen Member Engagement

With Health Cloud, payers can create customizable, interactive and highly personalized digital journeys for members, helping develop stronger relationships by overcoming barriers to care and increasing access to clinical and support services. Members can easily access their insurance plans, receive care alerts via their mobile device and connect with clinical professionals and care managers using email or text messages.

The Better Outcome: A case manager can proactively engage a member to arrange home care, rehab, and follow up hospital visits related to their procedure or service through the member’s preferred form of communication. Doing so advances their goal of driving optimal member outcomes.

Payer Educational Opportunity

Ad Victoriam Health Cloud Webinar

Ad Victoriam recently presented a webinar for payers, “Connecting Data to Transform Payer-Member Relationships,” during which attendees learned:

  • How connected member data can enhance your sales potential and member satisfaction.
  • Ways a modern system user interface can decrease training times and enhance the agent experience – increasing employee engagement.
  • How to invigorate marketing when data is no longer siloed.

Watch the free webinar here.

Interested in learning more about how Salesforce Health Cloud can transform your business operations and increase member engagement? Contact Ad Victoriam’s Health Cloud consultants quickly by filling out the form below or click here.

 

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Data Mining to Predict Marketing Success

Sales Data to Cloud Post

You are a lot of different things. You may be a college graduate. You may be a parent. You may be single or married. You may own a home or rent an apartment.

There are countless pieces of information that make up YOU—the list is long. And, in the data world, those descriptors are points on a graph or information in a spreadsheet.

As a marketer or other business professional, you count on data— insights into personalities—to predict marketing success and help your business grow. Your job is to pull useful data and make predictions about what you should be doing with your products, services, marketing and more. What does that effort look like? This graphic explains it.

Here’s What You Need to Know about Data Mining and Predictive Analytics

When data mining and predictive analytics are done well, your company can understand the past, properly gauge what’s happening now, and successfully predict how consumers will respond to marketing and sales efforts in the future. Don’t wait to get your data working for you, speak to a marketing data expert today. 

Why Communication is Key: Integrating Your Data

Why Communication is Key: Integrating Your Data

Your business uses many applications and software already to bring in useful data to grow and better serve your customers. These applications, though they can be very different, can also work together to bring you even more success in learning your market, expanding your business, and making sense of the mountain of data. All of this is done through integrating your data.

According to IBM, data integration is the process of combining “data from disparate sources into meaningful and valuable information.” The data gathered from one application can easily be translated to any other application instantly, connecting all of the software your business uses with one another in a way that keeps up with how businesses work in this day and age.

Faster Access

By utilizing data integration, every bit of data your business receives on a daily basis is available on all platforms instantly, eliminating the hassle of switching back and forth to view, analyze, and act on the data collected.

Faster Decision-Making

With the implementation of data integration, and the faster access mentioned above, comes the ability to make business decisions many times faster than was previously possible, letting businesses stay up to date with their market. Data that is integrated and viewable from all sources also offers a more holistic view of your business, allowing decisions to be made based on the whole picture – not just a piece of the pie.

Faster Adjustments

When one piece of data changes within one application, businesses no longer have to enter other enterprise applications to change the data manually. With data integration, these changes and adjustments can be taken care of in moments, making faster turnaround for your business the new reality.

Many say that the first step to efficient data integration is realizing its high importance in the business world. Luckily, Ad Victoriam Solutions offers many data integration options to help your business keep track of its data and maintain beneficial communication between applications. Contact us to find out how we can help your systems and applications communicate better.

4 Big Data Strategies that Can Improve Your Company

4 Big Data Strategies that Can Improve Your Company

Data is an essential part of most companies; however, in the last five years, data collection has evolved. Previously, companies would be required to collect their data daily and load it into a database. Today, click-steam data collection is more common. This method of data collection has led to an explosion of data sources and the creation of what we call “big data,” and as a result, data strategies are becoming part of many companies business focus.

The existence and complexity of big data has led to a need to be able to contain and process such massive quantities of information. In order to accomplish this monumental task, companies must develop a big data plan for managing, storing and using the flood of information.

Here are four common big data strategies business implement to do just that:

Strategy A: Use Performance Management for Organization

Performance management (PM) creates a way to understand the big data that naturally flows into a medium or large-sized company. PM uses both a series of pre-determined queries (to organize the data sets) and multidimensional analysis (a process of grouping big data into categories including dimensions and measurements). Moreover, PM systems can hold years of a company’s data, which can then be used for any number of reports and graphs to analyze business trends.

Strategy B: Make Data Exploration Work for You

Data exploration uses experimentation (specifically of website components to achieve high traffic conversion rates) and statistical data to answer questions about the health of a company. In terms of experimentation, companies can use data exploration to determine which website mockup will perform best, which content will be most useful to users, which landing pages and/or designs will lead to clicks, etc.

Strategy C: Analyze the Impact of Social Media

Social analytics is becoming increasingly important to companies as an increasing amount of data is being drawn from social media platforms. For example, a good deal of data comes from reviews via Facebook, Yelp and Twitter. Recently there has been an influx of mobile apps, like Foursquare, that are also generating a lot of data. Measuring the engagement of customers using these social platforms is a great way to stay ahead of the competition who may be ignoring this crucial data source.

Strategy D: Decision Science

Like social analytics, decision science takes non-transactional data and experiments with it to enhance a company’s decision-making. Often this type of data comes from consumer ideas, as well as product reviews. Decision science data, unlike social analytics, is used to test company hypotheses.

As the Ivey Business Journal states, managers don’t have to just pick one big data strategy, rather “the most effective companies leveraging big data today are combining strategies.” Implementing an effective big data strategy is about finding the best combination of data management practices to fit your individual company’s needs.

Here at Ad Victoriam Solutions, our big data and data intelligence consultants can not only help you map out a data management plan, we also provide the solutions and help you need to get the job done. We’re with you from start to finish!

If you require data strategies for translating data into useful solutions for your business, browse our blog or contact us and we’ll devise a way to enhance your company and solve all of your cloud-computing needs.