RESOURCE CENTER

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Payers: Build trusted member and provider relationships

Build member and provider trust with personalized, guided experiences

Health insurance companies must balance both member and provider relationships. An integrated, AI-powered platform allows payers to unify data and streamline operations to build more intelligent end-to-end experiences, improve affordability, reduce provider friction, and scale collaboration between distributed care teams.

Disconnected systems tend to slow down the processes that make these experiences possible, which is why prioritizing connected tools and technologies is so important. An integrated system allows payers to unify data and operations to build better end-to-end experiences, improve affordability, reduce provider friction, and scale collaboration between distributed care teams.

Disconnected systems slow down the processes that make these great end-to-end experiences possible. They also leave AI-powered solutions with less data to work with. This makes prioritizing data harmonization alongside integrated tools and technologies incredibly important– especially as it relates to the strength of your AI capabilities.

Accelerating relationships with actionable data and predictive capabilities not only strengthens your relationships, it makes your overall operation drastically more efficient. When members and providers feel seen, heard, and engaged, a more trusting and loyal relationship can be built. In fact, members who trust their insurers are more satisfied with their overall experience.

78% of consumers with a trusted relationship believe their health insurer genuinely cares about their health as compared to 3% of consumers who do not trust their insurer

Source: "Connected Health Consumer," Salesforce Industry Research, 2021.

Technology helps payers solve common pain points by:

Integrating data into a single console

PAIN POINT

Difficult and time-consuming tools and systems mean that the majority of member interactions are reactionary rather than proactive.

ANTIDOTE

Integrating all relevant member data — from benefits and claims, to clinical events and wellness programs — into a single console allows payers to gain insights and prioritize actions that will lead to the best outcomes. This boosts member satisfaction, and makes plan renewal more likely.

Digitizing, scaling and personalizing customer service and call center operations

PAIN POINT

Customer service can be manual and cumbersome, leading to poor member experiences that impact trust and loyalty.

ANTIDOTE

A centralized platform digitizes customer service. This gives call center agents a 360-degree view of each member as well as the tools they need to increase productivity. An integrated healthcare platform also enables payers to employ automated, AI-powered solutions that make it possible to do things like audit caller interactions, ensure compliance, and maintain a high standard of quality across all interactions. This ensures more positive, responsive, personalized experiences, and helps payer call centers resolve cases in a faster, smarter, and more compliant manner.

Strengthening, growing and managing a network of providers

PAIN POINT

Participating providers often encounter a disconnected, inefficient experience with their health insurance partners, making it difficult to collaborate or connect with new, eligible members.

ANTIDOTE

A single, connected system makes it possible to quickly grow and manage a network of providers, improve collaboration and make better member-patient connections. Payers can use an automated, digitized credentialing process to onboard providers more efficiently, and engage new or existing providers with targeted campaigns. The platform also provides self-serve experiences that allow providers to see the status of their application and easily manage data, inquiries, care processes, and their overall profiles.

Leveraging data to create more personalized care and long-term engagement

PAIN POINT

It’s difficult for payers to identify and manage high-risk members and to target those who have been flagged as “not engaged” in wellness or disease management plans.

ANTIDOTE

An integrated, AI-powered healthcare platform can help payers leverage cohort data to more easily create personalized, post-acute care plans and long-term engagement. Unified member health data like claims, labs, pharmacy, EMR, assessments, and social determinants drive insights and make it possible to calculate health scores that identify at-risk members so that they can be engaged for more optimal outcomes. In addition, the ability to aggregate and analyze data like medication reviews, drug-to-drug interactions, and documented discrepancies and recommendations, enables payers to promote safety, reduce readmissions, and refine future intervention strategies.