With the traditional, stress-filled fourth-quarter-stretch quickly approaching, we decided to sit down with Selerix Director of Quality Assurance, Isabel Bresnahan. An instrumental member of the Selerix family for nearly a decade now, Isabel spearheads the effort to ensure Selerix casebuilds meet our organization’s rigorous quality standards. In this interview, Isabel shares four critical tips to help you and your team avoid the most common Q4 casebuild issues.

Tip #1: Assumptions can be risky - confirm, confirm, confirm!

While renewal casebuilds can seem straight forward on the surface, when basic details are not confirmed, it could spell trouble for your clients. Confirming plan rules each year is a critical step in creating a consistent outcome for your casebuild process. Situations change, plans/products shuffle; even if it appears that nothing has changed, make the process of obtaining concrete confirmation a habit.

High Deductible and HSA plans are prime examples of commonly overlooked opportunities for updates. Have HSA limits changed for the current year? Are the dependencies between HDHP, FSA & HSA plans set correctly? Additionally, other product types may have rate guarantees for two or three years and those rates may increase automatically. Evidence of Insurability rules may change from year to year as well. While these may seem like basic case build principles, it is easy to make a mistake; be sure to take your time on these details and confirm, confirm, confirm.

Tip #2: Document everything and establish a process that works for your team.

We’ve all been there – a mad scramble in the midst of fourth-quarter to locate critical details surrounding a time-sensitive case build. The process of building a case can be complex at times; it involves a considerable number of moving parts. Establish a healthy habit of documentation and organization within your team - it can work wonders with streamlining your Q4 builds. Keep the lines of communication open with your clients and ask questions; this can supercharge the level of detail obtained during the implementation process.

At Selerix, we have developed our own workbook – a document that allows our Client Service team to document each stage of the implementation process and ask the right questions along the way. When working to establish a unified format within your team, obtaining buy-in from all stakeholders is critical. Be sure to include all members of your team as you develop/refine a process that works for you and your clients.

Tip #3: Data is king.

Let’s face it – even the most accurate, timely casebuild means nothing if the data within the case is incorrect or missing altogether. Data is the foundational building block of any successful casebuild, open enrollment season, and ongoing administration year. Invest the time early and often with your clients to set realistic expectations and timelines for obtaining clean, accurate data. The investment of ensuring your client’s data is up to date will pay dividends down the road when it’s time to deliver files to 3^rd-party vendors. Avoid coverage and billing nightmares by developing processes that make the transfer of data as easy as possible.

As a client of Selerix, you have access to tools like Census Expert – a tool that simplifies the process of working with data files. Contact your Selerix representative to learn more about how Census Expert can help your team’s data management efforts.  

Tip #4: Testing – the final frontier.

By far, one of the most valuable strategies to employ this fourth-quarter is a solid approach to testing your casebuilds. When testing your casebuilds, it is critical that multiple parties (other than the casebuilder) thoroughly test the final version of the case. When appropriate, involving the client in the testing process is a great approach – after all, clients know their rules best. Your testing strategy should include in-depth testing of all plans/products in the case. Issues are bound to come up, but the sooner your team can identify these discrepancies, the sooner the case can be ready for open enrollment. Test early and often to ensure your Q4 builds are in great shape for this year’s enrollment season!

Be sure to stay tuned for additional content from our Selerix Expert Series!

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